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 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: PEOUtah.Putnam@gmail.com. Carole Putnam Fund Committee serving May 2, 2016 to May 6, 2017 Chair: Diane Vanos, N 801-631-4104 Sally Pick, AJ 435-649-9881 Sandy Nichols, V 801-944-9335 Advisor: Stephanie Halton, Treasurer 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. 1
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 are met. 2
Requirements and Policies - page 2 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. 4. Submit annual reports on new recipients to the committee by March 15th. 3
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. 4
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) Date Chapter approval voted 5
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? Signature of applicant 6
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) 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) 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): TOTAL EDUCATION EXPENSE Number of Months per Term: If you have other resources for the requested grant, please list them: 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.) I confirm that this financial statement is correct to the best of my knowledge. applicant s signature date 7
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. Retain summary with application in files of Sponsoring Chapter and State Committee Chair for one year. 8