Indiv. Conference Confirmation Survey

GLOBAL UNITED DIASPORA

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Impactful Individual Questionnaire

* Indicates required field

Name(First, Last) *

3. What are the general philanthropic fields you focus on? *

Health Education Agriculture Water Sanitation & Resources Community Development Technology Disaster Relief Infrastructure Sustainable Design Homelessness

Select all that apply

Other *

4. List the your most notable projects or accomplishments,( project name, year, location.) *

For example: Rain Water Harvesting Tank , 2017 - Orphanage in Colombia: Helped Build Clinic, 2016, Nigeria

Project 2 *

Project 3 *

Project 4 *

5. Please provide any additional information about your charitable or innovative work that might be of benefit for the organizers to know. *

6. What skills would you like to gain during this conference? *

i.e. Grant Writing, Fundraising Insight, Securing Donors

7. What are some of your largest challenges within your work that you wish to overcome during the next 2 years? *

i.e Lack of funding, Project Management, Lack of organization, Identifying qualified staff.

8. Do you know any other impactful individuals that would be a good candidate for the Afro- Philanthropic conference? If so, please list them and a possible contact. *

9. What is a workshop that you feel you and other Black Philanthropist/ Innovators can benefit from at the conference? (apart from Fundraising, Grant Writing etc.) *

i.e. Measuring Impact, Marketing your cause

10. Which of the service projects with us during your time in Ghana are your members interested in participating in? (If any) *

Medical Outreach and Clinics Youth Empowerment and Sports Camps Beautification and upkeep of grounds at Orphanage

11. Do you have any special skills, certifications, knowledge set that may be of great benefit for the other organizations and individuals attending? *

Please provide contact information for the contact person to discuss details

Name *

First

Last

Email *

Phone Number *

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