Last Name:

Initial:

First Name:

Title:

Representing:

Address:

City:

State:

Zip:

Telephone:

Fax:

Email:

1. How are you currently involved in planned giving?

• I'm a Gift Planning Officer for a charity - involved exclusively or nearly so in planned giving.
• I'm a Development Officer for a charity; I'm involved in the following areas:
  • Current fund raising:
    • Annual
    • Capital
    • Campaign
    • Special
  • Deferred Giving/Gift Planning
  • Development Administration/Management
• I'm an Administrative Officer for a charity involved in:
  • Current fund raising:
    • Annual
    • Capital
    • Campaign
    • Special
  • Deferred Giving/Gift Planning
  • Development Administration/Management
• I'm a fund raising Consultant employed:
  • • Full-time
    • Part-time
    • Self
    • Other and I consult in
      • Annual
      • Capital
      • Campaign
      • Special
      • Planned/Deferred gifts
• Public Professional Financial/Legal Advisor/Practitioner/Vendor:
  • Attorney
  • Accountant/CPA
  • Trust Officer
  • Life Underwriter
  • Securities Broker
  • Realtor
  • Financial Planner
  • Other
    • Other:

2. How long have you been involved in your profession?
Years

3. To what degree have you been involved with charitable gift planning?

• Considerable
• Limited
• Very Limited
• Not at All

4. What professional, certificates, degrees, designations, etc. do you hold?

5. To what other professional-related organizations do you belong?

6. How do you expect/hope to be involved with WMPGG?

• Attend meetings/absorb information
• Make presentations to WMPGG membership at regular meetings
• Attend the NCPG annual Conference or Planned Giving (October)
• Provide leadership to WMPGG (officer, director, committee involvement)
• Represent WMPGG at the NCPG Assembly of Delegates
• Serve government relations efforts
• Other

7. What do you hope to get out of your membership in the WMPGG?

• Planned Giving training at the
  • Basic
  • Intermediate
  • Advanced level in the following:
    • New program set-up
    • Program administration
    • Marketing
    • Solicitation
    • Tax and Legal
    • Charitable Estate Planning
    • Other:
• Make professional contacts and enjoy professional comradeship and interaction
• Serve the gift planning profession
• Other:

8. How did you learn about the WMPGG?

• WMPGG Member
• Professional colleague
• Other:

As a condition of membership in the Western Michigan Planned Giving Group by submitting this form, I hereby subscribe to the NCPG Model Standards for the Charitable Gift Planner.