Prospective Investor/Grantmaker Non-Member Application for Confluence's 2019 Practitioners Gathering

**Invited speakers are not required to complete this form and will receive registration information separately.**

Question Title

* 1. Required Information

First and Last Name

Organization Affiliation

Title

Telephone

How did you hear about the Practitioners Gathering?

Approximate grant-making per year?

Current amount of Assets Under Management?

Are you with an endowed foundation?

Why are you interested in attending the conference?

Might you consider Confluence membership now or at a later date?

Thank you for your interest in our 9th Annual Practitioners Gathering in Brooklyn, NY. We will try to respond promptly to your attendance request. If you have any questions please feel free to contact david@confluencephilanthropy.org.

Question Title

* 1. Required Information

Question Title

* 2. Is your organization a member of any of the following membership groups?