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The EWL application is available in Microsoft Word or Acrobat format. Please click on the appropriate link below to download the application as needed. Feel free to copy as many as needed.
Download Application:
Microsoft Word (.doc) format
Adobe Acrobat (.pdf) format
Completed applications (for women who wish to be seen in the Albemarle, Charlottesville, Greene, Louisa, Madison, Orange and surrounding area)
may be faxed to our office at (434) 243-9784 or mailed to:
Every Woman's Life
University of Virginia Health System
P.O. Box 800334
Jefferson Park Avenue
Charlottesville, VA 22908
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2009 Federal Poverty Guidelines
(Effective 2/1/09 through 1/31/10)
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Household Size
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Gross Yearly
Salary
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Gross Monthly
Income*
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Approximate Hourly
Income**
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1
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$21,660.00
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$1,805.00 |
$10.41 |
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2
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$29,140.00
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$2,428.00 |
$14.01
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3
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$36,620.00
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$3,052.00 |
$17.61
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4
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$44,100.00
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$3,675.00 |
$21.20
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| 5 |
$51,580.00 |
$4,298.00 |
$24.80
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6
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$59,060.00
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$4,922.00 |
$28.39
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| 7 |
$66,540.00 |
$5,545.00 |
$31.99
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| 8 |
$74,020.00 |
$6,168.00 |
$35.59
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For each
additional
person, add: |
$7,480.00 |
$623.00 |
$3.60 |
*Yearly income divided by 12 Months
**Assumes a full-time job for a full year (2080 hours)
SOURCE: Federal Register, Vol. 74, No 14, January 23, 2009, pp.1499-4200.
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