IF YOU HAVE ALREADY COMPLETED THIS FORM FOR A PREVIOUS CREDENTIAL PLEASE PROCEED DIRECTLY TO YOUR EXAM

(Candidates only need to complete this form one time!)

The questions that follow ensure your education and professional training are officially recorded at NANOE's headquarters.

There are no trick questions. There are no right or wrong answers. Use this opportunity to memorialize your professional accomplishments in support of your forthcoming credential.

Questions marked with an * are required. Please NO BLANK FIELDS. If you've determined that a question does not apply please type N/A (not applicable).

The following process document is divided into TWO sections. You may stop and save your work at any time you wish by clicking "Save and Continue Later" at the bottom of the form. You will be emailed a custom link that will bring you back to your save point. You may save as many times as you wish before submitting the form.

*1. NAME & EMAIL

FORMAL EDUCATION

Formal Education IS NOT REQUIRED to be eligible to receive any credential. List all degrees you have, starting with associate degrees and ending with doctorate(s). This section is not limited to the past three years. Identify name of degree as indicated on your transcript or diploma; college/university name and year completed.

6. HIGHER ED CERTIFICATIONS

Higher Ed Certifications ARE NOT REQUIRED to be eligible to receive any credential. What certifications from a college/university do you have? Include any certification received regardless of type. Indicate name of certification, name of granting university/college, year awarded. Example: Certificate #1 - Nonprofit Management Certificate; Duke University, NC, 2011.

7. ASSOCIATION CERTIFICATIONS

Professional Association Certifications ARE NOT REQUIRED to be eligible to receive any credential. What certifications do you have from professional associations? Indicate name of certification, name of granting association, year awarded. Example: Certificate #1 - Marketing Certificate; Association of Doctors & Nurses; 2010.

8. CONTINUING EDUCATION (within past 5 Years

PLEASE NOTE: If you HAVE NOT achieved any of the previously mentioned degrees or certifications please demonstrate in the following section a minimum of 25 hrs in Adult Continuing Education (relating to nonprofit management) within the past five years.

Identify continuing education (CE) experiences you have had over the past five years (no more than 25 hrs). Give name of seminar/course/workshop, sponsoring agency, year, number of instructional hours involved. Example: Course #1 - Identifying donor prospects in my community; Duke University Center on Nonprofit Management, NC; 2010; 6 hrs.

9. PROFESSIONAL PRESENTATIONS

PLEASE NOTE: If you HAVE NOT achieved any of the previously mentioned degrees or certifications please demonstrate in the following section a minimum of 25 hrs in Adult Continuing Education (relating to nonprofit management) within the past five years.

Identify continuing education (CE) experiences you have had over the past five years (no more than 25 hrs). Give name of seminar/course/workshop, sponsoring agency, year, number of instructional hours involved. Example: Course #1 - Identifying donor prospects in my community; Duke University Center on Nonprofit Management, NC; 2010; 6 hrs.

10. AUTHORSHIP

List up to 10 publications written on nonprofit management and/or fundraising matters. These should be pieces published by other than your organization unless your organization publishes books, articles, magazines as part of its services (e.g. news articles, journal articles, magazine articles, book chapters, books, etc.). Give complete citation on each (.i.e. author(s), year published, name of publication, publisher town, state, publisher name). Example: Doe, John. (2010). Creating Interesting Direct Mail. NY, NY: X Publishers.

11. Please provide three references who will attest to your competencies in leading or playing a major role in the development, implementation and/or evaluation of nonprofit fundraising initiatives.