BIFAD Speaker/Author Information Form

3/2/23, 9:27 AM

BIFAD Speaker/Author Information Form

BIFAD Speaker/Author
Information Form
OMB: XXXX-XXXX
Expiration Date: XX/XX/XX
Thank you for joining the program as a speaker or panelist (or Author) for the [Enter Event or
Study Project]. Information in this form will be used to communicate with BIFAD stakeholders
and to ensure your name, position, and other information are communicated accurately and
according to your preference on the event flyer, website, presentation, post-event report, and
any pre- and post- event products related to the event.
BIFAD is committed to increasing diversity, equity, inclusion, and access in the board's
engagement and in global development more generally. This effort can be enhanced with
reliable information about our stakeholders. If you choose to respond to all or some of the
questions, information will remain confidential, with individual information not reported beyond
the project team.
Paperwork Reduction Act Statement: 
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor
shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a currently valid OMB Control Number. The OMB Control Number for this information
collection is XXXX-XXXX. Public reporting for this collection of information is estimated to be
approximately one minute per response.
Fields with (*) denotes a required field.

* Required

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BIFAD Speaker/Author Information Form

1

Name as you would like for it to appear on the program: 
First/Given Name:
Last/Family Name: *

2

Preferred Prefix: *

Mr.
Mrs.
Ms.
Miss
Dr.
Engineer (Eng.)
Professor (Prof.)
Her/His Excellency
Ambassador
Other

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BIFAD Speaker/Author Information Form

3

Title: *

4

Organization(s) Name: *

5

What are your preferred pronouns? *

6

What is your current gender identity? *

Woman/girl
Man/boy
Additional gender identity
Prefer not to answer

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BIFAD Speaker/Author Information Form

7

Would you like for your organization to be tagged in social media promotions
or posts about this event or product? If yes, please include information about
a. Link to Twitter:
b. Link to Facebook:
c.
Link to LinkedIn:

8

Preferred Email:

9

Preferred Phone

10

WhatsApp Number:

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BIFAD Speaker/Author Information Form

11

Professional Biography: Please include a link to your preferred professional
biography, or otherwise insert biographical details (professional experience,
education, areas of specialty, etc.) in the textbox below. Generally, bios of 120150 words are preferred.

12

Professional Photo: Please provide a link to your preferred professional photo
or email your photo to: [email protected]
Generally, photos with the dimensions or file size of 4x6 and 1200x1800 pixels
are preferred *

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BIFAD Speaker/Author Information Form

13

Organization Type (select most relevant response below): *

Prefer not to answer
U.S. University
University outside the U.S.
U.S. Agency for International Development
Other U.S. Government
Non-U.S. Donor Organization
Non Profit Organization
Firm
Independent Consultant
Publicly Traded Organization
Other

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14

For faculty, staff, and students of U.S universities only, is your university
identified as any of the following Minority Serving Institution (MSI) types?

Alaska Native-Serving Institution (ANSI)
Asian American Native American Pacific Islander-Serving Institution (AANAPISI)
Historically Black College or University (HBCU)
Hispanic-Serving Institution (HSIs)
Native American-Serving Non-Tribal Institution (NASNTI)
Native Hawaiian-Serving Institution (NHSI)
Predominantly Black Institution (PBI)
Tribal College or University (TCU)
No
I don't know

15

What is your age group?

Prefer not to answer
18-24 years old
25-29 years old
30 years and older

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BIFAD Speaker/Author Information Form

16

What is your country of residence?

Select your answer

17

If you selected the United States of America as your country of residence, what
are your racial and ethnic identities? (please select all identities with which you
identify)

Prefer not to answer
Asian
American Indian or Alaska Native
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
North African or Middle Eastern
White

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BIFAD Speaker/Author Information Form

Thank you for collaborating with BIFAD!

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