BIFAD Speaker/Author Information Form

BIFAD Speaker/Author
Information Form
OMB: 0412-0623
Expiration Date: 05/31/2026
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 0412-0623. Public reporting for this collection of information is estimated to be
approximately one minute per response.
Fields with (*) denotes a required field.

* Required

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

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

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:

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 *

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
Government non-U.S.
Non-U.S. Donor Organization
Non Profit Organization
Firm
Independent Consultant
Publicly Traded Organization

Other

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

16

What is your country of residence?

Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium

Belize
Benin
17

If you
selected the United States of America as your country of residence, what
Bhutan
are your racial and ethnic identities? (please select all identities with which you
identify)
Bolivia
Prefer
answer
Bosnianot
andtoHerzegovina
Asian
Botswana
American
Indian or Alaska Native
Brazil
Black
Bruneior African American
Hispanic
Bulgaria or Latino
Native
or Pacific Islander
BurkinaHawaiian
Faso
North
African or Middle Eastern
Burundi
White
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia

Comoros

Thank
Congo you for collaborating with BIFAD!
Costa Rica
Côte d'Ivoire
Croatia
Cuba
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Cyprus
Czech Republic (Czechia)
Denmark
Djibouti
Dominica
Dominican Republic
DR Congo
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
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ti i

Microsoft Forms

Eswatini
Ethiopia
Fiji
Finland
France
Gabon
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland

India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia

Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro

Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay

Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts & Nevis
Saint Lucia
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sl

ki

Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Vincent & Grenadines
State of Palestine
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
The Gambia

Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia

Zimbabwe