Project Deserve Application PDF Details

Deserving a project is an important aspect of getting it funded and completed. The Project Deserve Application Form helps project managers and those submitting proposals to provide all the necessary details for their project. This ensures that those reviewing and approving projects have all the information they need to make an informed decision about whether a particular project deserves funding. Project Deserve is an online application form that provides a simple, intuitive platform for creating, submitting, and tracking proposals. This allows individuals or groups to communicate their proposal idea with others in order to build consensus and gather required approvals before submission. It also makes it easy for reviewers to access all proposal materials in one place, removing the hassle of having to track down messy email attachments or misplaced document files.

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QuestionAnswer
Form NameProject Deserve Application
Form Length4 pages
Fillable?Yes
Fillable fields135
Avg. time to fill out28 min 4 sec
Other namesproject deserve application, project deserve application wichita ks, center of hope, project derserve

Form Preview Example

Project DESERVE Application

This program provides assistance to current Westar Energy customers with active service in their name. Applications may be submitted by mail to Center of Hope Inc., P.O. Box 3237, Wichita, KS 67201; by fax (316) 267-7778; or by email ProjectDeserve@centerofhopeinc.org. Online registration is available at centerofhopeinc.org. Please see page 3 for other important information and requirements. Assistance is determined on the basis of need, subject to the availability of funds.

To be eligible for this program, a member of your household must meet one of the following categories:

65 Years or Older or receives

OR

permanent disability income from

 

SSI or SSD

 

If approved, you will be assisted with the amount due on your account at the time of review, up to $200.

Meets the income guidelines below

If approved, you will be assisted with the amount due on your bill at time of review, up to $200.

Household information

List all members of your household. Your utility bill must be in the name of an adult living in the household. Begin on line 1 with the account holder’s name. Please print

Name (Last, First, MI)

Social Security #

Sex

(For all in household)

(Adults only)

M or F Age

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Household

Net Income

(not including food

 

stamps)

 

Size

Annual

Month

1

$13,850

$1,154

2

$15,800

$1,317

3

$17,800

$1,483

4

$19,750

$1,646

5

$21,350

$1,779

6

$22,950

$1,913

7

$24,500

$2,042

8

$26,100

$2,175

 

 

 

Applicant’s telephone:

 

Applicant’s email:

 

 

 

 

 

 

 

Street address

City

State

Zip

County

Please indicate with a check () why you need assistance with your bill:

Not enough monthly

Loss of

Unusually high

Unusually high

income

income

utility bill

medical bill

Other (please explain)

 

 

 

 

 

 

 

 

 

 

 

Page 1 of 3

 

 

Please list the following information from your utility bill:

Name of utility: ______________________________

Account number: ____________________________

Budget Information

MONTHLY EXPENDITURES

Amount

Regular

paid this

monthly

 

month

expenses

 

 

 

Rent

 

 

 

 

 

Electric

 

 

 

 

 

Gas

 

 

 

 

 

Water

 

 

 

 

 

Trash

 

 

 

 

 

Cable

 

 

 

 

 

Internet

 

 

 

 

 

Phone

 

 

 

 

 

Food stamps

 

 

Food (own $)

 

 

Household

 

 

Clothes

 

 

 

 

 

Laundry

 

 

 

 

 

Vehicle (payment)

 

 

 

 

 

Vehicle insurance

 

 

 

 

 

Gas/transportation

 

 

 

 

 

Other insurance

 

 

 

 

 

Credit card payments

 

 

 

 

 

Pay day loan payments

 

 

 

 

 

Student loan payments

 

 

 

 

 

Other loan payments

 

 

 

 

 

Child care

 

 

 

 

 

Medical/hospital

 

 

Tithes/contributions

 

 

Cigarettes/alcohol

 

 

Recreation

 

 

Fines

 

 

 

 

 

Other

 

 

 

 

 

TOTAL*

 

 

* Total must agree with total cash received

Total bill amount: ____________

Income Information

Name of person

Source

Amount

 

 

 

 

 

$

 

 

$

 

 

$

 

 

$

 

 

$

 

 

$

 

 

$

 

 

$

Monthly income total

 

$

 

Friend

 

Borrowed

Family

$

(check all that apply)

Payday

 

 

loan

 

Total cash

$

received*

 

*Total cash received must agree with monthly expenditures paid this month

IMPORTANT!

Please include ALL household income for all household members regardless of age or relationship.

Source examples include: employment, SSD, SSI, SS, TAF, food stamps, unemployment, worker compensation, child support, alimony, pension, VA benefits, etc.

Each source requires official written verification. Examples of verification include: paycheck stubs for most recent 30 days, letter from Social Security office (for current year), printout from DCF, printout from unemployment office, etc.

PLEASE DO NOT SEND ORIGINAL DOCUMENTS – ONLY SEND COPIES. ALL DOCUMENTS WILL BE DESTROYED AFTER REVIEW.

Please read the next page (p. 3) very carefully

Page 2 of 3

Required Verification

To have your application for assistance considered, written verification of your situation is required. Along with this signed application, you must provide COPIES of the following:

Current verification for each source of income in your household for the most recent 30 days

Current utility bill

One other utility bill or phone bill in your name at this address

DO NOT include originals as they will not be returned to you. All documents will be destroyed after review.

Notification Information

You will be notified, in writing, of our decision. Please allow up to 4 weeks to receive notification by mail. Please return completed application and verification using one of the following:

Fax: (316) 267-7778

Email: ProjectDeserve@centerofhopeinc.org

Mail: Center of Hope Inc.

Project DESERVE

P.O. Box 3237

Wichita, KS 67201

Online: centerofhopeinc.org

READ THE FOLLOWING CAREFULLY BEFORE SIGNING

My signature below means that I understand and agree to all of the following:

I understand it is my responsibility to provide current proof of all household income, a current copy of my utility bill and another monthly bill in my name to determine my eligibility.

I understand I need to continue making regular payments to my energy provider and that any Project DESERVE benefits which may be received do not take the place of my responsibility to pay the vendor.

I understand my eligibility will be determined under the Project DESERVE guidelines.

I understand this assistance is available only one time in a rolling 12-month period to those who demonstrate a financial need.

I authorize my utility provider to release my payment history and other information to Center of Hope Inc. I also authorize Center of Hope Inc. to release application information to my energy vendor.

I understand applications with incomplete information or verification will not be processed and will be destroyed.

I certify that all information I have provided is complete and accurate.

( )

Signature of adult household member

Date

Daytime phone number

Page 3 of 3

Project DESERVE

P.O. Box 3237

Wichita, KS 67201

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example of blanks in project deserve application wichita ks

Type in the necessary particulars in the segment Month, Size, For, all, in, household Adults, only Age, Sex, Mor, F and Applicants, email

Finishing project deserve application wichita ks step 2

In the section discussing cid, Other, please, explain cid, Not, enough, monthly cid, Loss, of, income utility, bill income, City, State, Applicants, email Page, of Zip, County, cid, Unusually, high and medical, bill it's essential to write down some essential particulars.

Finishing project deserve application wichita ks part 3

The Total, bill, amount Income, Information Name, of, person Source, Amount, Budget, Information MONTHLY, EXPENDITURES Amount, paid, this, month Regular, monthly, expenses and Monthly, income, total section allows you to specify the rights and responsibilities of each party.

Filling out project deserve application wichita ks part 4

Check the sections Amount, Borrowed, check, all, that, apply Friend, Family cid, cid, cid, Payday, loan Total, cash, received and IMPORTANT and thereafter fill them out.

Filling out project deserve application wichita ks step 5

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