CAROLE PUTNAM FUND Application Guidelines

CAROLE PUTNAM FUND

The Carole Putnam Fund (CPF) is a Utah P.E.O. philanthropic project for Utah women. Established in 2001, the CPF provides a one-time scholarship to a woman who is seeking education leading to a certification or a license that is not part of a degree program. Examples but not limited to: Realtor, cosmetologist, massage therapist, Montessori teacher, yoga instructor, CNA, LPN, etc. She must have a realistic educational goal and demonstrate financial need. The recipient must be a Utah resident and be recommended by a Utah P.E.O. chapter. The scholarship amount varies and applications are accepted at any time during the year.

Please visit www.peoutah.org for the most recent application. Application forms and committee contact information can be found in the Members-only section of the website on the Carole Putnam Fund webpage.

Sponsoring P.E.O. chapters should mail or deliver applications completed in full to the CPF chairperson (for address, visit www.peoutah.org). A checklist of required documents is included with this application. Please allow the committee six weeks to process the

application. Upon favorable vote of the committee, the Utah State Treasurer will disburse the funds to the designated institution.

The CPF committee uses a shared email address for Carole Putnam Fund business. Contact the Chair and her committee by emailing: [email protected].

Carole Putnam Fund Committee – serving May 5, 2015-May 11, 2016 Chair: Linda Nicoson, AH 801-540-9964

Diane Vanos, N 801-394-1309

Sally Pick, AJ 435-649-9881

NOTE: Be advised that receipt of a Carole Putnam Fund award may impact any government assistance the applicant is receiving. The applicant should contact the government agency prior to completing this application to insure continued receipt of assistance fund.

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CAROLE PUTNAM FUND

Requirements and Policies - page 1

1. The applicant shall:

a. be a woman sponsored by a Utah P.E.O. chapter, who resides in Utah.

b. show a documented need for Carole Putnam Funds to pursue an education leading to a certification or a license that is not part of a degree program.

2. Applications may be received throughout the year but are awarded on a one-time basis.

3. The sponsoring chapter will to the best of its ability verify the applicant's need. The Committee reserves the right to request further written documentation verifying that need.

4. Each application must be complete at the time of submission.

5. Each application is evaluated on its own merit and funded in accordance with the applicant's demonstrated need and the fund's resources at the time of the application.

6. CPF recipients will report in writing to their sponsoring chapter by March 1st about use of funded monies.

7. Each sponsoring P.E.O. chapter will forward all one-year reports with a photo and short biography of the recipient to the CPF committee no later than March 15th of the upcoming year.

8. CPF committee will report to the P.E.O. state board at the Utah P.E.O. state convention about the annual awards and the reports from subsequent rewards.

9. Upon favorable vote of the committee, the Utah State Treasurer will disburse the funds to the designated institution.

ELIGIBLE CANDIDATES FOR THE AWARD SHALL BE 1. A woman residing in Utah during the time she will receive and use the funds; 2. Known and sponsored by her local P.E.O. chapter;

3. In need financial assistance to seek education leading to a certification or a license that is not part of a degree program.

4. Willing and able to demonstrate need through documentation, if requested. REQUIRED FORMS

1. Chapter Application Form—Sponsoring P.E.O. Chapter completed. 2. Applicant Case History—Applicant completed.

3. Statement of Income and Expenses with any requested documentation—Applicant completed. 4. Summary of Application - Chapter completed.

OTHER REQUIRED APPLICATION SUPPORT 1. Sponsoring P.E.O. chapter letter of recommendation

2. Applicant letter describing reasons for requesting funds, providing personal history leading to request, a statement of goals, and responses to the questions below.

a. Which of your accomplishments have given you the greatest satisfaction? b. What experiences have challenged you the most?

c. Why have you chosen to pursue your education and in which particular field or toward a specific career?

d. Where would you like to be in five years?:

3. Two written non-family reference letters from professors, supervisors, employers, etc. 4. Transcript of grades from latest course of study (college, high school) or GED certificate 5. Documentation of acceptance and/or that necessary requirements to take this course of study

CAROLE PUTNAM FUND

SUCCESSFUL CANDIDATE RESPONSIBILITIES:

1. Provide a written report with verifying documentation (certificate or school records) describing the use of the CPF funds to sponsoring chapter in a time frame suitable to the chapter's reporting needs, but no later than one year from the award.

SPONSORING CHAPTER RESPONSIBILITIES:

1. Get to personally know the applicant, her needs and her goals

2. Email or mail a photo and short biography of the successful applicant to the CPF committee no later than March 15th.

3. Maintain contact with recipient on a regular basis for the first year.

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Checklist for Application Submission

Please be sure that all items are correct and complete before submitting your application to the Carole Putnam Chairman. If you have questions about any of the requirements, please contact the Carole Putnam Chairman.

□ Summary of Application Form—Sponsoring chapter completed □ Chapter Application Form—Sponsoring chapter completed □ Sponsoring chapter's letter of recommendation

□ Applicant’s letter describing reasons for requesting funds, providing personal history leading to request and a statement of goals. Include answers to the following questions:

a. Which of your accomplishments have given you the greatest satisfaction? b. What experiences have challenged you the most?

c. Why have you chosen to pursue your education? d. Where would you like to be in five years?

□ Applicant Case History—Applicant completed

□ Statement of Income and Expenses—Applicant completed

□ Two written non-family references from professors, supervisors, employers, etc.

□ Transcript of grades from latest course of study (college, high school) or GED certificate □ Documentation of acceptance and/or necessary requirements to take this course of study are met

Chapters - review application, forms, and letters for accuracy and completeness before submitting to CPF Chairman.

Chapter Application

Sponsoring Chapter _____ Date ___________________

Contact information for chapter project chair:

______________________________________________________________________________

(name) (phone) (email)

______________________________________________________________________________

(street address) (state) (zip code)

1. Applicant:___________________________________________________________________

(name) (Email)

______________________________________________________________________________

(street address) (city) (state) (zip code)

______________________________________________________________________________

(phone number) (date of birth)

2. IF APPLICANT IS A MEMBER OF THE P.E.O. SISTERHOOD:

A. Where and when initiated________________________________________________ B. Present membership: Chapter ______________; State ___________________

Active ________________ Inactive _____________ If inactive, for how long? __________________________ Years of membership in present chapter ______________

3. IF APPLICANT IS NOT A MEMBER OF THE P.E.O. SISTERHOOD: A. Who referred applicant to the P.E.O. Sisterhood for aid?

_____________________________________________________________________

(Name) (Chapter)

_____________________________________________________________________

(Street Address) (Phone Number)

_____________________________________________________________________

(City) (State) (Zip Code)

B. Any relationship between applicant and a member of the P.E.O. Sisterhood:

(Please be specific, if none, write none.)

_____________________________________________________________________ 4. Amount of assistance requested $______________When needed? ______________________ 5. Specify to whom or what institution the check should be written________________________

Signed ______________________________ _________________________________

(Chapter President) (Chapter Recording Secretary)

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Applicant Case History

Date ___________________

1. Name of applicant ________________________________________________________

(name)

________________________________________________________________________

(mailing address) (city) (state) (zip code)

________________________________________________________________________

(phone number) (Email)

2. Date of birth ______________________

3. Highest level of education completed: _________________________________________ 4. Amount of assistance requested? __________________________________________

a. When is assistance needed__________________________________________ b. Purpose of assistance______________________________________________

5. Have you applied for other grants or assistance; and if so, to what organizations; for how much money; and what is the expected date of notification?

Statement of Income and Expense

The applicant should complete the following, in full, for the time period in which the grant would be used. The figures should correspond to an achievable goal with the aid of funds received from the Carole Putnam Fund.

MONTHLY INCOME (deduct taxes withheld)

Salary: Applicant $______________

Spouse / Domestic Partner $______________ Financial Aid: (actual per month)

Scholarships, grants $______________

Loans $______________

Child Support/alimony: $______________

Welfare assistance/food stamps: $______________

Other income $______________

TOTAL monthly income ** $______________

ADDITIONAL INFORMATION .

Total in Savings Accounts $______________

Total in Checking Accounts $______________

Total in Investments $______________

(please list on separate sheet)

Total educational loans to date $______________ Total Debts:

Mortgage, credit cards, loans, etc. $______________

EDUCATIONAL EXPENSE PER TERM .

Tuition $______________

Books/Educational Supplies $______________ Transportation (to/from class) $______________ Childcare (related to education) $______________ Other: ____________________ $______________ Other: ____________________ $______________ Other: ____________________ $______________

TOTAL EDUCATION EXPENSE $______________

Number of Months per Term: _____

MONTHLY EDUCATIONAL EXPENSE:**$___________

**(Divide total educational expenses amount by the number of months in each term. Place this figure in the appropriate line of the Monthly Expense column.)

MONTHLY EXPENSES Rent/mortgage payment $______________ Food/groceries $______________ Utilities $______________ Telephone $______________ Personal expenses:

Clothes, activities, etc. $______________

Medical/Dental $______________

Automobile: Payment $______________

Insurance $______________

Expense $______________

Insurance: home, health, life, etc. $______________

Loan/charge payments $______________

Childcare (not education related) $______________ Other: ____________________ $______________ Other: ____________________ $______________ Other: ____________________ $______________

TOTAL PERSONAL MONTHLY EXPENSE $___________

(add monthly expenses above)

MONTHLY EDUCATIONAL EXPENSE** $_____________

(ADD ** from lower left column)

TOTAL monthly expenses ** $_____________ ** If there is a shortfall between total income and total expenses, list how much and how it is being funded, including family, credit cards, other (use other side if

necessary):______________________________________

________________________________________________ If you have other resources for the requested grant, please list them: _________________________________ ________________________________________________

I confirm that this financial statement is correct to the best of my knowledge.

________________________________________________ applicant’s signature date

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Summary of Application

REQUIRED

LOCAL CHAPTERS MUST COMPLETE

Applicant’s Name: _____________________________________________________________ Date chapter committee received application: _______________________________________ Date sponsoring chapter approved application: ______________________________________ Amount of aid requested:________________________________________________________ Date when aid is needed: ______________________________________________________ Name of educational institution, seminar or workshop: _________________________________ Make check payable to : ________________________________________________________ Name of School, Seminar or Conference

Checks are mailed to chapter to be presented to recipient.

Mail to: _______________________________________ Chapter: _______ _______________________________________

_______________________________________

FOR CAROLE PUTNAM COMMITTEE USE ONLY

Date state committee received application: ________________________________________

Application approved: Yes____ No_____ Date: ___________________________________ Amount of aid granted: $_______________________

Signed: ___________________________________________ State Committee Chair

Committee Chair, upon approval of the committee, please provide a copy of this form to the Utah State Treasurer for processing.