Name

Organization

Address

City, State, Zip

Daytime Phone Number

E-Mail Address (required)

I will be attending

Full Day     
Morning & Lunch (Half Day)  Lunch & Afternoon (Half-Day) 

I prefer the following breakout sessions:
Note: Space is limited. Preference will be given on a first-come basis.

Morning Breakout Sessions (select one):

SESSION FULL  1.A  Major Gifts
1.B  Effective Communications
1.C  Special Events

Afternoon Breakout Sessions (select one):

2.A  CFRE Panel Discussion
SESSION FULL  2.B  Annual Giving as the Foundation of Your Development Plan
2.C  Working with Your Board

I am a member of AFP:  Yes  No 

Costs:

AFP Members: $95 full day • $65 half day
Non-Members: $145 full day • $105 half day

Total amount you will pay for CSI:  $

Every Member Campaign Contribution:  $

Everyone who contributes to the EMC by 1:00 PM on September 19th will be entered into a drawing to receive gift baskets and other nice door prizes.

Payment option:

Check Make checks payable to the AFP North Central Ohio Chapter

Charge my credit card:  __ Visa         __ Mastercard
       Will appear as “INFO LINE” on your statement

Number _____________________________ Exp _________

Signature ________________________Security Code_____

• If you are paying by check: Mail this completed form with your check to AFPNCOH, 703 South Main Street #211, Akron OH  44311.
• If you are paying by MasterCard or Visa: Print this form, write down your credit card information, and fax this completed form 330-315-0399.

Questions for the speaker(s):