HELEN ABBOTT FUND. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 1

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Lydia Lewis
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The Helen Abbott Fund (HAF) is a Utah P.E.O. philanthropic project for Utah women. HAF was established in 1952 to provide Utah P.E.O. sisters emergency funds in times of financial crises.

1 The Helen Abbott Fund (HAF) is a Utah P.E.O. philanthropic project for Utah women. HAF was established in 1952 to provide Utah P.E.O. sisters emergency funds in times of financial crises. Since then, the Fund has extended its mission to offer not only P.E.O. members but also P.E.O. sponsored non-members a one-time financial award to aid in an immediate emergency or to support their educational pursuit in a degree or certification program at a Utah post-secondary institution, including on-line university/colleges located in Utah. Both of these awards are to assist Utah women in overcoming specific emergencies either in their personal lives or in the continuation of their education. The Helen Abbott Fund Committee and an Adviser from Utah State Chapter administer the Fund. Applications may be received throughout the year but are awarded in accordance with the fund s resources. Approval of awards is at the discretion of the Helen Abbott Fund Committee and amounts will not exceed $1500. Chapters, please visit for the most recent application. Application forms and committee contact information can be found in the Members-only section of the website on the Helen Abbott Fund webpage. Sponsoring P.E.O. chapters should mail or deliver applications completed in full to the HAF chairperson (for address, visit A checklist of required documents is included with this application. Please allow the committee six weeks to process the application upon its receipt. The HAF committee uses a shared address for Helen Abbott Fund business. Contact the Chair and her committee by ing: PEOUtah.Abbott@gmail.com Helen Abbott Fund Committee serving May 3, 2015 to May 1, 2016 Chair: Karen Elkington, P Michelle Fleck, B JoAnn Albro, AE NOTE: Be advised that receipt of an HAF 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. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 1

2 Application Requirements 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 Helen Abbott Funds either for 1. emergency assistance; or 2. an accepted student in a degree or certification program at a post-secondary Utah educational institution. This can include on-line university/colleges located in Utah. 2. Applications may be received throughout the year but are awarded on a one-time basis. 3. Each application will designate for what purpose the funds are requested a) emergency funds or b) educational funds and be accompanied by the appropriate financial statement. 4. The sponsoring chapter will to the best of its ability verify the applicant's real need. The committee reserves the right to request further written documentation verifying that need. 5. Each application must be complete at the time of submission, which includes a completed summary cover sheet. 6. 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. 7. HAF recipients will report in writing to their sponsoring chapter by March 1st on the use of the funded monies. 8. Each sponsoring P.E.O. chapter will forward a photo, signed Release of Information form and short biography of each recipient to the HAF committee no later than March 15th of the current year. 9. HAF committee will report to the P.E.O. state board at the Utah P.E.O. state convention about the annual awards. 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. Need financial assistance to meet a real and threatening personal emergency; OR 4. Need financial assistance to pursue her education in a degree or certification program at a postsecondary Utah institution; and 5. If requested, willing and able to demonstrate need through documentation. REQUIRED FORMS FOR BOTH EMERGENCY AND EDUCATIONAL APPLICATIONS: 1. Case History Applicant completed. 2. Chapter Application Form Sponsoring P.E.O. Chapter completed. 3. Helen Abbott Fund Statement of Income and Expenses with any requested documentation Applicant completed. 4. Copy of acceptance to or registration in post-secondary degree or certification program in a Utah educational institution. 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? Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 2

3 Application Requirements - continued EMERGENCY FUNDS APPLICATION SHOULD INCLUDE: 1. One non-family letter of reference. 2. Financial Statement Form A EDUCATIONAL FUNDS APPLICATIONS SHOULD INCLUDE: 1. Two non-family references from supervisors, employers, or professors. 2. Transcripts from all colleges/trade schools/etc. attended by the applicant. 3. Proof of registration in a post-secondary Utah institution. 4. Financial Statement Form B SUCCESSFUL CANDIDATE RESPONSIBILITIES: 1. Provide a written progress report describing the use of the HAF 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. or mail a photo and short biography of the successful applicant to the HAF committee no later than March 15th. 3. Maintain contact with recipient on a regular basis for the first year. 4. Within one year of award, follow up with the recipient to obtain her written progress report, to be shared with your chapter and forward a copy to the HAF chairperson. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 3

4 Checklist for Application Submission Please be sure that all items are correct and complete before submitting your application to the Helen Abbott Fund Chairman. If you have questions about any of the requirements, please contact the Helen Abbott Fund Chairman. Summary of Application Form Sponsoring chapter completed Case History Applicant completed Chapter Application Form Sponsoring chapter completed Financial Statement Applicant completed (Make sure the applicant completes either Form A for Emergency Funds or Form B for Educational Funds. Do not submit both forms A and B.) Sponsoring chapter's letter of recommendation. Applicant letter describing reasons for requesting funds, providing personal history leading to request, and a statement of goals. For Emergency Fund requests only, also include: One written non-family letter of reference. Financial Statement Form A. For Educational Fund requests only, also include: Two written non-family references from professors, supervisors, employers, etc. Transcripts from all colleges/trade schools/etc. that the applicant has attended. Financial Statement Form B. Proof of registration in a degree or certification-granting post-secondary Utah Institution. Review application, forms, and letters for accuracy and completeness before submitting to HAF. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 4

5 Chapter Application Circle one: Emergency Assistance Educational Assistance Sponsoring Chapter Date Contact information for chapter project chair or sponsoring member: (name) (phone) ( ) (street address) (state) (zip code) 1. Applicant: (name) ( ) (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 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) Date Chapter approval voted Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 5

6 Applicant Case History Circle one: Emergency Assistance Educational Assistance Date 1. Name of applicant (name) (mailing address) (city) (state) (zip code) (phone number) ( ) 2. Date of birth 3. Health of applicant 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? Signature of applicant *** Please sign and return this form and the completed financial statement along with your detailed personal letter to chapter committee chairman and other supporting letters and documentation. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 6

7 FORM A HELEN ABBOTT FUND Statement of Income and Expense FOR EMERGENCY FUND APPLICANTS 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 Helen Abbott Fund. MONTHLY INCOME (deduct taxes withheld) Salary: Applicant Husband/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 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) TOTAL monthly expenses ** ** If there is a shortfall between income and expenses, list how much and how is it being funded, including family, credit cards, other: I confirm that this financial statement is correct to the best of my knowledge. applicant s signature date Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 7

8 FORM B HELEN ABBOTT FUND Statement of Income and Expense FOR EDUCATIONAL FUND APPLICANTS 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 Helen Abbott Fund. MONTHLY INCOME (deduct taxes withheld) Salary: Applicant Husband/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) 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) TOTAL PERSONAL MONTHLY EXPENSE $ (add monthly expenses above) ADD ** from lower left column) MONTHLY EDUCATIONAL EXPENSE** $ 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 Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 8

9 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: Purpose of need - Assistance or Educational: If Educational, name of institution: If Assistance, purpose of funds: Make check payable to : (Applicant Name or School) Checks are mailed to chapter to be presented to recipient. Mail to: Chapter: FOR HELEN ABBOTT 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. Retain summary with application in files of Sponsoring Chapter and State Committee Chair for one year. Utah P.E.O. Helen Abbott Fund Application - Revised 5/5/2015 Page 9

CAROLE PUTNAM FUND Application Guidelines

CAROLE PUTNAM FUND Application Guidelines Application Guidelines 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