New Club Funding Form

New Club Funding Form

Live Your Dream Awards
Thank you for participating in the Soroptimist Live Your Dream Awards!

Instructions:

Please complete this form, attach a copy of your club recipient’s application and at least one reference (a second is optional), and submit it to SIA headquarters by February 1 in order to receive the $1,000 award for your first Live Your Dream Awards recipient.

Before beginning, please make sure you have a copy of your club’s top recipient’s application and at least one reference on your local computer—you may need to scan it or save it from your email to your computer. You will need to upload them to this form.

The award funds will be transferred electronically to the club or region via ACH/wire transfer. Depending on where your club is located, you will be asked to provide your bank information on this form.

Keep a copy of the application and completed reporting form for your files (a copy of your submitted report will be emailed to you).

If you ever need assistance, please email lydawards@soroptimist.org and we will be happy to help.
Our Club:
Club Name:*
Club Number:*
Charter Date:*
Please select your Region:*
Our Club's Live Your Dream Awards Recipient:
Recipient Name:*

First NameLast Name
Mailing Address:*
City:*
State/Province:*
Postal Code:*
Country:
Phone Country Code:
Phone Number:
Email:*
example@example.com
Check the box below if the recipient does not have an email address
Please upload the recipient's Application and at least one Reference:*

Required for submitting to SIAHQ
Cancelof

How to Save Your Form
To save and return to this reporting form at a later time, click "Save."

You will be prompted to create an account on the online platform which hosts the Live Your Dream Awards New Club Funding Form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Domestic ACH Payment Agreement
Name on Bank Account:*
Bank Name:*
Bank Account Number:*
Bank Routing Number:*
Account Type (choose one):*

CheckingSavings
Print Name:*
I hereby agree to allow Soroptimist International of the Americas, Inc.® to deposit payments directly to the above bank account through ACH. Please print and sign name below.
Signature*

Clear

How to Save Your Form
To save and return to this reporting form at a later time, click "Save."

You will be prompted to create an account on the online platform which hosts the Live Your Dream Awards New Club Funding Form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Please select how you would like to receive your award funds:

International WirePayPal

Information Needed for International Wire Request

Bank Information
Bank Information

Please provide a letter from your bank on bank letterhead verifying the bank’s international incoming wire instructions.

They may also include any additional instructions or information that your bank requires for you to receive an ACH/wire transfer of funds. This will ensure that we get all the information we need to send your funds in a timely way.
Upload Letter from Bank*

Cancelof
Beneficiary Name:*
Must be as it is listed on the account.
Beneficiary Address:*
Please include the FULL address (all parts of the street address, city, postal, state/region, country).
Account Number:*
International Bank Account Number (IBAN):*
(up to 34 characters long)
Bank Name:*
Bank Address:*
SWIFT Code*:*
*What’s a SWIFT code? A SWIFT code is 8-11 characters with letters and numbers. A representative at your bank should be able to provide you with this number that is unique to your bank. http://www.theswiftcodes.com/
Intermediary bank information (if applicable)
Intermediary bank name:
Intermediary bank address:
Account number:
International Bank Account Number (IBAN):
(up to 34 characters long)
SWIFT Code*:
*What’s a SWIFT code? A SWIFT code is 8-11 characters with letters and numbers. A representative at your bank should be able to provide you with this number that is unique to your bank. http://www.theswiftcodes.com/

How to Save Your Form
To save and return to this reporting form at a later time, click "Save."

You will be prompted to create an account on the online platform which hosts the Live Your Dream Awards New Club Funding Form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

PayPal
Do you have a PayPal account?*

YesNo
You will need to have an account to receive money through PayPal.

Please create an account or change your response to the previous question to "International Wire" and provide the requested information.

Click here for instructions on creating a PayPal account.
Is this your club PayPal account or personal PayPal account?*

Club AccountPersonal Account
All of the information below must agree to the club’s corresponding PayPal account.
Please make sure all the information below corresponds to the same PayPal account.
Name on the Account*
Username (@username)*
Email*
Mobile Number*
In submitting this form, I agree to the following:

I am accepting this New Club Funding on behalf of my club.I will ensure that the funds will transferred to my club and used in its entirety for the funding of a Live Your Dream Award.
Name:*
Signature:*

Clear

How to Save Your Form
To save and return to this reporting form at a later time, click "Save."

You will be prompted to create an account on the online platform which hosts the Live Your Dream Awards New Club Funding Form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Your award funds of $1,000 will be sent directly to your region. Please contact your region to coordinate fund disbursement.
Feedback:
We are constantly trying to improve our programs and appreciate feedback from our members and clubs. Please tell us about your experience participating in the Live Your Dream Awards. Did you find it rewarding? Challenging? Are there any resources or additional aid SIA could provide to make participation more gratifying?
Submitted By:
Name:*

First NameLast Name
Email:*
example@example.com
Save or Review/Submit
TO SUBMIT:

If you are ready to SUBMIT your report, please click "REVIEW ANSWERS" below.

Please review your report. When you have finished, you will find the "SUBMIT" button at the bottom right of the page.

TO SAVE:

If you are not ready to submit, and would prefer to save and return to this reporting form at a later time, click "Save."

You will be prompted to create an account on the online platform which hosts the Live Your Dream Awards New Club Funding Form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.
Should be Empty:

New Club Funding Form

Our Club:

Our Club's Live Your Dream Awards Recipient:

Domestic ACH Payment Agreement

Information Needed for International Wire Request

PayPal

Feedback:

Submitted By:

Save or Review/Submit