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Created: 01/27/2016 Last updated: 03/09/2016 Page 1 General information Organization The Victoria Foundation/ Grant Park Contact First name Mary Rose Contact Last name Wilcox Contact e-mail grantparkaz@gmail.com Contact phone number 602-739-5900 Address Street 701 South 3rd Avenue City Phoenix State Arizona ZIP Code 85003 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request 22,925 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program from the Gila River Indian Community, enter the amount to be requested each year. Amount Year 1 (Gila River Indian Community Grants Only) Year 2 (Gila River Indian Community Grants Only) Year 3 (Gila River Indian Community Grants Only) Year 4 (Gila River Indian Community Grants Only) Year 5 (Gila River Indian Community Grants Only) 1 of 1 OCT 20 2C00 Internal Revenue Service _LCIZAR. Department 5 :: the Treasury Director, Exempt Organizet ion LAW HMO q30 Rulings and Agreements Cincinnati, Ohio 45201 Date: OCT 15 2008 Person to Contact: Joe Kennedy THE VICTORIA FOUNDATION INC ID# 31-08655 C/O MARY SUE LOTZAR Contact Telephone Numbers: 6263 N SCOTSDALE ROAD SUITE 216 1-877-829-5500 SCOTTSDALE, AZ 85250 Federal Identification Number: 23-7091708 Dear Madam: This modifies our letter dated April 1974. In that letter we determined that your organization is exempt under section 501(a) of the Internal Revenue Code, as an organization described in section 501(c)(3). We later determined that you were a publicly supported organization within the meaning of section 509(a) (2) af the Code. In your letter dated July 24, 2008, you requested classification as an organization no longer described in section 509(a)(2) of the Code. Based on the information you provided, we have determined that you meet the requirements for foundation classification under sections 509(a)(1) and 170(b)(1)(A)(vi). Accordingly, we have granted your request and modified your foundation status to reflect an organization described in sections 509(a)(1) and 170(b)(1)(A)(vi). Your organization is required to file an annual Form 990, Return of Organizations Exempt from Tax, by the 15" day of the fifth month after the end of your annual accounting period, when your gross receipts exceed $25,000. If your gross receipts are $25,000 or less, you must file an annual electronic notice, Form 990-N. Your exempt status under section 501(a) of the Internal Revenue Code, as an organization described in section 501(c)(3) remains in effect. Grantors and contributors may rely on this determination until the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a)(1) and 170(b)(1)(A)(vi) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act that resulted in your loss of such status, or acquired knowledge that the Internal Revenue Service had given notice that you would be removed from classification as a section 509(a)(1) and 170(b)(1)(A)(vi) organization. Because this letter could help resolve any questions about your exempt status and/or foundation status, you should keep it with your permanent records. Page 2 r THE VICTORIA FOUNDATION INC 23-7091708 If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely, Robert Choi Director, Exempt Organizations Rulings and Agreements Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/26/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County 3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Supervisor Clint Hickman 4. Mailing Address: 301 West Jefferson, 10th Floor 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Clint Hickman Signature: Applicant Information 7. Department/Organization Name: The Victoria Foundation, INC./ Grant Park Recreation and Community Center 8. Is this a non-profit 501c(3) Organization? No Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Mary Rose Wilcox Title: Co-Director, Finance Chair 10. Phone Number: 602-739-5900 11. Mailing Address: 1122 E. Buckeye Rd Ste. B5 12. City: Phoenix State: Arizona Zip Code: 85034-4019 13. Email Address: mrosewilcox@yahoo.com Website Address: Click here to enter text. Project Information 14. Project Name: Late Night Basketball 15. Purpose of Grant: The Late Night Basketball Program seeks funding to promote total wellness in families by offering positive recreational activties to at-risk youth encouraging them to stay in school, resist drugs and criminal activity. 16. Priority Funding Area Healthcare 17. Annual amount requested $22,925.00 18. Number of years that funding is requested 1 19. Total amount requested (annual amount x $22,925.00 # of years) 20. Has your organization received past No funding from GRIC? If yes, list each year and amount Grant Park Recreation and Community Center is located in City 21. Geographic area served Central South (CCS). CCS is approximately two square miles and is For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Grant Cycle 2016 bound by the Pacific Railroad tracks on the north, the Maricopa Freeway (1-17) to the west and south and Central Avenue on the east. Gila River Indian Community Grant Application Grant Cycle 2016 Narrative Please structure your proposal to provide the following information in the order indicated. Provide the narrative in paragraph form in the text field provided. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. The Victoria Foundation is a 501 © (3) created in 2008 under the auspices of a Community Development Corporations. The foundation offers grants in four areas: arts/culture, economic development/affordable housing, education, and faith-based initiatives. The scope of service expanded in February 2011, when The Victoria Foundation, INC. entered into a five-year public/private partnership with the City of Phoenix, Parks and Recreation Department. For five years The Victoria Foundation, INC. has provided recreational, educational and cultural programming at Grant Park Recreational Center under direction of Earl and Mary Rose Wilcox. Grant Park Recreation and Community Center served approximately 18,765 participants in 2015 as a vital hub for youth activity. (City of Phoenix Annual Report, 2015) The Center offers the annual Diamondback Jam; a 40-year legacy Late Night Basketball Program in partnership with the Phoenix Suns; offers tutoring to students of neighboring elementary schools on Tuesdays, Wednesdays, and Thursdays and opportunities to earn online high school diploma/credit recovery, GED training, and enrichment courses. 2. If the organization is a non-profit 501c(3), please describe your relationship with the municipality including past and present support, whether it be through partnerships, collaborations, in-kind contributions, grants, tax-based funding or other. If the organization is a municipality governmental sub-division please enter the text “Not applicable.” The Victoria Foundation, INC. / Grant Park Recreation and Community Center co-sponsored the Late Night Basketball Program with co-founder, former Maricopa County Supervisor Mary Rose Wilcox. This partnership was established in 2010. From 1993 to 2014 Maricopa County District 5 staffed, organized, programmed and marketed the program. Upon Mrs. Wilcox’s retirement in 2014, the program administration transitioned to The Victoria Foundation, INC. The Late Night Basketball program is open to all Maricopa County residents, but focuses on low income residents in inner-city Phoenix neighborhoods. The Victoria Foundation, INC. seeks to work with Maricopa County Public Health in the 2016- 2017 program year, introducing the Late Night Back to School Bash- a community health fair. 3. Describe the proposed project and planned goals and activities. Forty years ago, a late night Basketball program was started by Earl and Mary Rose Wilcox, in an effort to keep youth off the streets on Friday and Saturday nights when crime was at peak. Late Night Basketball, has had an enormous impact on the community. According to City of Phoenix crime statistics, juvenile crime rates have been reduced by about 17% in inner city neighborhoods where the program is run. The Late Night Basketball Program aims to touch 2000 people through a series of events that foster total wellness, physical activity and community enrichment. The program targets youth that cannot afford to play in club competition. Gila River Indian Community Grant Application Grant Cycle 2016 In August 2017, the program is introducing the Late Night Back to School Bash. This event provides youth with haircuts and other resources help students get a healthy start to the school year Outreach for all activities is done through Phoenix Elementary School District #1, Roosevelt School District and Phoenix Union High Schools. Please find below an outline of scheduled events. Free Holiday Classic Winter Tournament (December 2016) Two divisions with four teams each division. High School- Girls High School-Boys Free Basketball Round Robin Tournament- (August- to September 2017) Five divisions with four teams each division. Participants get tournament jersey for games. 12 and under –Boys/Girls 15 and under- Girls 15 and under- Boys High School- Girls High School-Boys Kids Café (May 2017 to August 2017) Summer nutrition program in partnership with the St. Mary’s Food Bank Alliance Kid Café provides meals to Grant Park Basketball teams before and after practice during the summer months. Back to School Bash Community Health Fair (August 2017) A community event aimed to prepare youth and families for a successful school year. Event will offer: Free Haircuts Free Sports physicals Food Boxes Nutrition workshops Opportunities and support to families applying for affordable health care on the Federal Marketplace in the Grant Park computer lab. Free Basketball Skills Clinic at the Talking Stick Arena 8:00am- 11:30am (date TBD September 2017) Basketball Skills Camp targeting 200 youth Ages 8 to 14 (3rd grade to 8th grade) Workshops on sportsmanship and teambuilding. Each participant will receive a camp shirt and basketball. 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. The Late Night Basketball program promotes healthy lifestyles; providing recreational activities that promote physical fitness, balanced nutrition, and early substance abuse prevention. 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Approximately 61% of the residents of CCS live below the federal poverty line. More than half of these people are single women with children (CCS Quality of Life Plan, 2010). According to the 2010 Census, 62% of the youth (under 18) living Gila River Indian Community Grant Application Grant Cycle 2016 in this sector of Phoenix live with their grandmother and another 35% percent of children live in non-family households. An attributing factor to the number of children in out of home placement is due to Department of Child Safety (DSC) involvement and/or parental custody issues related to incarceration, drugs and alcohol issues. Currently, half of our youth participants are under DCS surveillance. Youth are exposed to violence, gang activity, prostitution and drugs. Many of our families face a considerable amount of stress finding safe, reliable, and affordable activities for youth during the summer months. 6. Define the project as a new or continuing program. Late Night Basketball is a continuing program and has been in existence for 40 years. (see attached LNB Program 2014) 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. The program activities will start in December 2016 with the Holiday Classic and end in September of 2017 with the Late Night championship games. Tournament dates are flexible, however the date of the championship games is firm once scheduled. 8. Identify other organizations, partners or funders participating in the project and their roles. Participating partners Include: St. Mary’s Food Bank Alliance- A partnership which provides breakfast and lunch before and after in December, and May through August. Phoenix Suns- Donate use of the Talking Stick Arena for Late Night Basketball championship games and basketball skill camp on Labor Day weekend. Pepsi- Traditionally donates water and Gatorade for the Holiday Classic, Late Night tournament, skills camp, and championship games. American Legion Post 41 and Women’s Auxiliary members- Volunteer time contributing to the community celebration by preparing food, and serving families. City of Phoenix Parks and Recreation, Phoenix Police Department and Neighborhood services are co- sponsors of the event and help secure use of Grant Park Field, street closures, and security. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? Yes, Late Night Basketball can be implemented if the program is awarded partial funding. However, adjustments to the number of tournament days and number of participants will be necessary. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. The activities and strategies employed to sustain the Late Night Basketball program is continued fundraising, volunteer recruitment and building partnerships within our community. Our annual Grant Park Hall of Fame Luncheon will be held April 15, 2016, our fundraising goal for this event is 30,000.00 dollars. Fundraising provides approximately 50% of the Grant Park Recreation and Community Center operating budget. 11. Describe your plan to document progress and results. Gila River Indian Community Grant Application Grant Cycle 2016 The Late Night Basketball program staff work with the City of Phoenix Police Department and Lowell Elementary gathering statistical information to evaluate effectiveness. The program expects to measure an overall decrease in juvenile crime and negative attitudes towards education in the service area using quantitative and qualitative methods. Program Staff document demographic information and conduct surveys on services provided. 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. The Salt River Pima Maricopa Indian Community supported Late Night Basketball the following program years: 2008: Wilcox Late Night Basketball ($5000.00) 2009: Wilcox Late Night Basketball ($10,000.00) 2010: Wilcox Late Night Basketball ($10,000.00) 2011: Wilcox Late Night Basketball ($13,000.00) 2012: Wilcox Late Night Basketball ($13,000.00) 2013: Wilcox Late Night Basketball ($15,000.00) 2014: Wilcox Late Night Basketball ($15,000.00) Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: Click here to enter text. For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Late Night Program Staff $0 $3,000.00 $3,000.00 $6,000.00 2. Grant Park Recreational Center $0 $0 $5,500.00 $5,500.00 Rental 3. Community Events $1,480.00 $0 $1000.00 $2,480.00 4. Program Shirts and awards $7,900.00 $0 $0 $7,900.00 5. Officals $8,500.00 $0 $0 $8,500.00 6. Basketballs $1,875.00 $0 $0 $1,875.00 7. Supplies $870.00 $0 $0 $870.00 8. Food $500 $140.00 $1,000.00 $1640.00 9. Gatorade/water $0 $0 $2,000.00 $2,000.00 10. Program Insurance $1,800.00 $0 $0 $1,800.00 11. Click here to enter text. Click here to $0 $0 $0 enter text. 12. Click here to enter text. Click here to $0 $0 $0 enter text. 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $22,925.00 $3,140.00 $12,500.00 $38,565.00 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Detail Please provide a narrative description for each of the project budget items listed on the previous page. Include the dollar figure and how it was derived. 1. $3,000.00 is the cost of Late Night Basketball program staff for Holiday Classic, skills camp, tournament, and championship games. The program will have a total of 8 staff for the duration of the program working a total of 250 hours at $12.00 per/hr. The cost of staff is paid for by The Victoria Foundation/Grant Park general fund. Gene Albe (a tournament organizer) and Phoenix College Basketball Coach Matt Gordon donate a total of $3,000.00 in-kind service hours to the Late Night Basketball program. 2. $5,500.00 is the cost to rent the Grant Park Recreational Center gym for 50 days. The figure includes the cost of a Special Use Agreement for the outdoor courts, field, and picnic area. The Victoria Foundation/Grant Park provides gym in-kind and pays Special Use Agreement fee from Grant Park general fund. 3. $1,480.00 is the estimated cost for two community enrichment events sponsored by the Late Night Basketball Program. The first event is the Back to School Bash with an estimated budget of $400.00. These funds will be used to provide a community barbeque for 200 people ($400.00 food and paper products). Hair stylist and barbers will donate their time to cut kids hair. Program is working with Valle Del Sol to find Health Providers to donate time for Sports Physicals and Breaking Boundaries Ministries will help organize a food pantry for participants. The second event is the Late Night Basketball Awards Ceremony. The cost of entertainment is 300.00 for a DJ, and $80.00 to rent outdoor movie screen from City of Phoenix Councilman Michael Norwakowski’s District. The program will budget an additional $700.00 to provide food for awards ceremony serving 500 people. 4. $7,900.00 is the cost of program shirts, jerseys and awards. The Late Night Basketball team works with Thunderbird Trophies. They offer us a low rate of $6.00 dollars per camp shirt, and $15.00 dollars per tournament jersey. Program will order 250 camp shirts and 280 tournament jerseys. The cost for participation medals for skills camp is $4.00 per medal and the cost for trophies for 60 tournament winners and slam dunk competition is $20.00 per trophy. 5. $8,500.00 is the cost for game officials. During the Holiday Class, Late Night round robin tournament, and championship games we expect a total of 73 games. The cost of two official per/game is $110.00 6. 1,875.00 is the quoted cost of branded basketballs for the Late Night Basketball Skills Camp. The cost per/ball is $7.5 7. $870.00 is the cost for supplies needed for the program. The program will need to purchase 2 basketball score books for $20.00, 2 first aid kits, and spend $500.00 for printing of promotional materials. The program will also need markers, Gila River Indian Community Grant Application Grant Cycle 2016 printer ink, and paper for basketball skills camp registration table ($150.00). The program will use an additional $200.00 for photography of championship games. 8. $1640.00 is the total cost estimate for food at the championship games and tournament games. While at the Talking Stick Arena the Late Night Basketball program is required to purchase lunch from arena corporate sponsors. Last year we were quoted $489.00 dollar to cater lunch for 300 camp participants. Program will spend an addition $140 dollars on fresh fruit for championship game participants and snacks for skills camp. The budget includes in-kind contributions from the St. Mary Food bank to feed basketball teams after games during August tournament. Food from the St. Mary’s Food bank must be eaten in the Grant Park gym. 9. $2000.00 is the total in-kind contribution of Gatorade and water from Pepsi-Co. 10. $1,800.00 is the total cost of program insurance necessary to fulfill City of Phoenix Policy. This quote is from Estrella Insurance Company. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. WILCO LATE Nun BASKETBALL ToUNAMENT Honoring Councilman Michael E. Johnson 2013 Maricopa County BN PRC/1 -- PEPSICO e 1.-.I G Recreat Parks ions & Ply.4 each Anaccisuor Ne.p.bodwacl Maricopa County Maly Rose Wilcox Supervisor, District 5 301 Westierer son Street 10th Floor Phoenix, AZ 85003-2143 Phone: 602-506.3406 Late Night Basketball—fighting youth violence for 27 years WWW.R1 anCOpiLgOV September 01, 2013 To all the Wilcox Late Night Basketball supporters: Thank you for your involvement in this 27th year of the Wilcox Late Night Basketball program. We are proud to have had another successful program, and it would not have been possible without the support of our community and sponsors. Earl and I began Late Night twenty-seven years ago to combat crime and gang involvement among our youth. The program has been praised at the national level as a great method for preventing crime. Gangs, violence and drugs may appear enticing at times, but we believe there is a better path for our youth to take. Late Night Basketball 2013 is particularly special. First, because we are honoring Councilman Michael Johnson for his many years of support, second the Phoenix Suns have graciously allowed us to use the U.S. Airways Arena to run our skills camp and championship games and Third because we have invited Late Night alumni to come out for an All Star Veterans game. Again thank you for your support and see you next year. Your Friends, Mary Rose Wilcox Earl Wilcox Supervisor, District 5 Program Director LATE NIGHT BASKETBALL PHILOSOPHY The Wilcox Late Night Basketball Program seeks to provide creative alternatives for county-wide youths through the implementation of cultural and recreational activities for the purposes of the reduction of youth gang violence and criminal activity. 11-11 ist co r y Twenty seven years ago, a "Midnight Basketball" Program was started by Supervisor Mary Rose Wilcox (then on the Phoenix City Council) and her husband, Earl Wilcox, in an effort to keep inner city youth off the streets on Friday and Saturday nights when juvenile crime is at its peak. The dream was real and the method was simple—provide something constructive for kids to do. By supplying competition and a gym to play basketball in, the program was designed to give inner city youth a positive alternative to drugs, violence, and gang-involvement. Every year on championship day, the league and tournament culminates with a huge celebration at Grant Park. Over the last 27 years, Late Night Basketball, which is put together by the Hispanic Sports Authority in coordination with The Friendly House, Inc. and Maricopa County, has had an enormous impact in the community. According to the City of Phoenix crime statistics, the juvenile crime rate has been reduced by about 17% in the inner city neighborhoods where the program is run. From the numbers, it's obvious that Late Night Basketball has helped in reducing crime and preventing future problems. This year, Late Night Basketball serves youth throughout Maricopa County's District S. Participants who were impacted by the program years ago have come back to help today's at-risk youth. This year we have added an All Star veterans game where Late Night Alumni will come back and share their basketball talent. The program has evolved to be called "Wilcox Late Night Basketball" and has continued to grow over the past 27 years with assistance from countless sponsors and volunteers. 44-4 00 LATE NIGHT BASKETBALL Honoring Councilman Michael E. Johnson Councilman Michael Johnson, thank you for your twelve years of service to District 8 and your many years of support of the Late Night Basketball Program. Your hard work and dedication has benefited our community tremendously. Your slogan "I luv District 8" illustrates the sense of pride you have built in our community. We Luv District 81 LATE NIGHT BASKETBALL Grant Park Haii ot rame-Koiando Rhymes Rolando Rhymes is the son of Byron and Yvonne Rhymes. He is the youngest in a long history of high-level basketball players in the Rhymes family. In 2012/2013, Rolando led the Desert Mountain High School Wolves to a school record 26 wins, reaching the state semi-finals. Rolando is considered by sports writers and coaches as the fastest guard in Arizona. After leading his team in scoring ( 16 points per game), assists, steals, and second in team rebounds, he was named to the All-Arizona High basketball first team. Rolando has travelled throughout the United States competing in the highest level of competition. As an 8 th grader and freshman, he attended basketball camp at the prestigious Oak Hill Academy in North Carolina. As the 2013/2014 season approaches, Rolando is rated one of the top five prep players in Arizona. His unselfishness, and uncanny ball handing ability marks him as one of the most gifted athletes in high school basketball. Rolando is a product of the Phoenix inner-city and past participant of the Wilcox Late Night Basketball Program. He is the first athlete to be inducted in to the Grant Park Hall of Fame. LATE NIGHT BASKETBALL Tournament 2013 The Late Night Basketball program is coordinated through the leadership of the Wilcox family. Earl 8c Mary Rose Wilcox The Late Night Basketball Program would like to extend a special thanks to all our volunteers and sponsors. This program is a success because of your support and contributions. Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/26/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County 3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Supervisor Clint Hickman 4. Mailing Address: 301 West Jefferson, 10th Floor 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Clint Hickman Signature: Applicant Information 7. Department/Organization Name: The Victoria Foundation, INC./ Grant Park Recreation and Community Center 8. Is this a non-profit 501c(3) Organization? No Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Mary Rose Wilcox Title: Co-Director, Finance Chair 10. Phone Number: 602-739-5900 11. Mailing Address: 1122 E. Buckeye Rd Ste. B5 12. City: Phoenix State: Arizona Zip Code: 85034-4019 13. Email Address: mrosewilcox@yahoo.com Website Address: Click here to enter text. Project Information 14. Project Name: Late Night Basketball 15. Purpose of Grant: The Late Night Basketball Program seeks funding to promote total wellness in families by offering positive recreational activties to at-risk youth encouraging them to stay in school, resist drugs and criminal activity. 16. Priority Funding Area Healthcare 17. Annual amount requested $22,925.00 18. Number of years that funding is requested 1 For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Grant Cycle 2016 19. Total amount requested (annual amount x # $22,925.00 of years) 20. Has your organization received past funding No from GRIC? If yes, list each year and amount Grant Park Recreation and Community Center is located in City Central South (CCS). CCS is approximately two square miles and is bound by the 21. Geographic area served Pacific Railroad tracks on the north, the Maricopa Freeway (1-17) to the west and south and Central Avenue on the east. Gila River Indian Community Grant Application Grant Cycle 2016 Narrative Please structure your proposal to provide the following information in the order indicated. Provide the narrative in paragraph form in the text field provided. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. The Victoria Foundation is a 501 © (3) created in 2008 under the auspices of a Community Development Corporations. The foundation offers grants in four areas: arts/culture, economic development/affordable housing, education, and faith-based initiatives. The scope of service expanded in February 2011, when The Victoria Foundation, INC. entered into a five-year public/private partnership with the City of Phoenix, Parks and Recreation Department. For five years The Victoria Foundation, INC. has provided recreational, educational and cultural programming at Grant Park Recreational Center under direction of Earl and Mary Rose Wilcox. Grant Park Recreation and Community Center served approximately 18,765 participants in 2015 as a vital hub for youth activity. (City of Phoenix Annual Report, 2015) The Center offers the annual Diamondback Jam; a 40-year legacy Late Night Basketball Program in partnership with the Phoenix Suns; offers tutoring to students of neighboring elementary schools on Tuesdays, Wednesdays, and Thursdays and opportunities to earn online high school diploma/credit recovery, GED training, and enrichment courses. 2. If the organization is a non-profit 501c(3), please describe your relationship with the municipality including past and present support, whether it be through partnerships, collaborations, in-kind contributions, grants, tax-based funding or other. If the organization is a municipality governmental sub-division please enter the text “Not applicable.” The Victoria Foundation, INC. / Grant Park Recreation and Community Center co-sponsored the Late Night Basketball Program with co-founder, former Maricopa County Supervisor Mary Rose Wilcox. This partnership was established in 2010. From 1993 to 2014 Maricopa County District 5 staffed, organized, programmed and marketed the program. Upon Mrs. Wilcox’s retirement in 2014, the program administration transitioned to The Victoria Foundation, INC. The Late Night Basketball program is open to all Maricopa County residents, but focuses on low income residents in inner-city Phoenix neighborhoods. The Victoria Foundation, INC. seeks to work with Maricopa County Public Health in the 2016-2017 program year, introducing the Late Night Back to School Bash- a community health fair. 3. Describe the proposed project and planned goals and activities. Forty years ago, a late night Basketball program was started by Earl and Mary Rose Wilcox, in an effort to keep youth off the streets on Friday and Saturday nights when crime was at peak. Late Night Basketball, has had an enormous impact on the community. According to City of Phoenix crime statistics, juvenile crime rates have been reduced by about 17% in inner city neighborhoods where the program is run. The Late Night Basketball Program aims to touch 2000 people through a series of events that foster total wellness, physical activity and community enrichment. The program targets youth that cannot afford to play in club competition. In August 2017, the program is introducing the Late Night Back to School Bash. This event Gila River Indian Community Grant Application Grant Cycle 2016 provides youth with haircuts and other resources help students get a healthy start to the school year Outreach for all activities is done through Phoenix Elementary School District #1, Roosevelt School District and Phoenix Union High Schools. Please find below an outline of scheduled events. • Free Holiday Classic Winter Tournament (December 2016) Two divisions with four teams each division. High School- Girls High School-Boys • Free Basketball Round Robin Tournament- (August- to September 2017) Five divisions with four teams each division. Participants get tournament jersey for games. 12 and under –Boys/Girls 15 and under- Girls 15 and under- Boys High School- Girls High School-Boys • Kids Café (May 2017 to August 2017) Summer nutrition program in partnership with the St. Mary’s Food Bank Alliance Kid Café provides meals to Grant Park Basketball teams before and after practice during the summer months. • Back to School Bash Community Health Fair (August 2017) A community event aimed to prepare youth and families for a successful school year. Event will offer: Free Haircuts Free Sports physicals Food Boxes Nutrition workshops Opportunities and support to families applying for affordable health care on the Federal Marketplace in the Grant Park computer lab. • Free Basketball Skills Clinic at the Talking Stick Arena 8:00am- 11:30am (date TBD September 2017) Basketball Skills Camp targeting 200 youth Ages 8 to 14 (3rd grade to 8th grade) Workshops on sportsmanship and teambuilding. Each participant will receive a camp shirt and basketball. 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. The Late Night Basketball program promotes healthy lifestyles; providing recreational activities that promote physical fitness, balanced nutrition, and early substance abuse prevention. 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Approximately 61% of the residents of CCS live below the federal poverty line. More than half of these people are single women with children (CCS Quality of Life Plan, 2010). According to the 2010 Census, 62% of the youth (under 18) living in this sector of Phoenix live with their grandmother and another 35% percent of Gila River Indian Community Grant Application Grant Cycle 2016 children live in non-family households. An attributing factor to the number of children in out of home placement is due to Department of Child Safety (DSC) involvement and/or parental custody issues related to incarceration, drugs and alcohol issues. Currently, half of our youth participants are under DCS surveillance. Youth are exposed to violence, gang activity, prostitution and drugs. Many of our families face a considerable amount of stress finding safe, reliable, and affordable activities for youth during the summer months. 6. Define the project as a new or continuing program. Late Night Basketball is a continuing program and has been in existence for 40 years. (see attached LNB Program 2013) 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. The program activities will start in December 2016 with the Holiday Classic and end in September of 2017 with the Late Night championship games. Tournament dates are flexible, however the date of the championship games is firm once scheduled. 8. Identify other organizations, partners or funders participating in the project and their roles. Participating partners Include: • St. Mary’s Food Bank Alliance- A partnership which provides breakfast and lunch before and after in December, and May through August. • Phoenix Suns- Donate use of the Talking Stick Arena for Late Night Basketball championship games and basketball skill camp on Labor Day weekend. • Pepsi- Traditionally donates water and Gatorade for the Holiday Classic, Late Night tournament, skills camp, and championship games. • American Legion Post 41 and Women’s Auxiliary members- Volunteer time contributing to the community celebration by preparing food, and serving families. • City of Phoenix Parks and Recreation, Phoenix Police Department and Neighborhood services are co-sponsors of the event and help secure use of Grant Park Field, street closures, and security. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? Yes, Late Night Basketball can be implemented if the program is awarded partial funding. However, adjustments to the number of tournament days and number of participants will be necessary. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. The activities and strategies employed to sustain the Late Night Basketball program is continued fundraising, volunteer recruitment and building partnerships within our community. Our annual Grant Park Hall of Fame Luncheon will be held April 15, 2016, our fundraising goal for this event is 30,000.00 dollars. Fundraising provides approximately 50% of the Grant Park Recreation and Community Center operating budget. Gila River Indian Community Grant Application Grant Cycle 2016 11. Describe your plan to document progress and results. The Late Night Basketball program staff work with the City of Phoenix Police Department and Lowell Elementary gathering statistical information to evaluate effectiveness. The program expects to measure an overall decrease in juvenile crime and negative attitudes towards education in the service area using quantitative and qualitative methods. Program Staff document demographic information and conduct surveys on services provided. 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. The Salt River Pima Maricopa Indian Community supported Late Night Basketball the following program years: 2008: Wilcox Late Night Basketball ($5000.00) 2009: Wilcox Late Night Basketball ($10,000.00) 2010: Wilcox Late Night Basketball ($10,000.00) 2011: Wilcox Late Night Basketball ($13,000.00) 2012: Wilcox Late Night Basketball ($13,000.00) 2013: Wilcox Late Night Basketball ($15,000.00) 2014: Wilcox Late Night Basketball ($15,000.00) Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: Click here to enter text. For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget requested from requested or contributions (list each budget item) GRIC secured from other funders 1. Late Night Program Staff $0 $3,000.00 $3,000.00 $6,000.00 2. Grant Park Recreational Center $0 $0 $5,500.00 $5,500.00 Rental 3. Community Events $1,480.00 $0 $1000.00 $2,480.00 4. Program Shirts and awards $7,900.00 $0 $0 $7,900.00 5. Officals $8,500.00 $0 $0 $8,500.00 6. Basketballs $1,875.00 $0 $0 $1,875.00 7. Supplies $870.00 $0 $0 $870.00 8. Food $500 $140.00 $1,000.00 $1640.00 9. Gatorade/water $0 $0 $2,000.00 $2,000.00 10. Program Insurance $1,800.00 $0 $0 $1,800.00 11. Click here to enter text. Click here to $0 $0 $0 enter text. 12. Click here to enter text. Click here to $0 $0 $0 enter text. 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $22,925.00 $3,140.00 $12,500.00 $38,565.00 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Detail Please provide a narrative description for each of the project budget items listed on the previous page. Include the dollar figure and how it was derived. 1. $3,000.00 is the cost of Late Night Basketball program staff for Holiday Classic, skills camp, tournament, and championship games. The program will have a total of 8 staff for the duration of the program working a total of 250 hours at $12.00 per/hr. The cost of staff is paid for by The Victoria Foundation/Grant Park general fund. Gene Albe (a tournament organizer) and Phoenix College Basketball Coach Matt Gordon donate a total of $3,000.00 in-kind service hours to the Late Night Basketball program. 2. $5,500.00 is the cost to rent the Grant Park Recreational Center gym for 50 days. The figure includes the cost of a Special Use Agreement for the outdoor courts, field, and picnic area. The Victoria Foundation/Grant Park provides gym in-kind and pays Special Use Agreement fee from Grant Park general fund. 3. $1,480.00 is the estimated cost for two community enrichment events sponsored by the Late Night Basketball Program. The first event is the Back to School Bash with an estimated budget of $400.00. These funds will be used to provide a community barbeque for 200 people ($400.00 food and paper products). Hair stylist and barbers will donate their time to cut kids hair. Program is working with Valle Del Sol to find Health Providers to donate time for Sports Physicals and Breaking Boundaries Ministries will help organize a food pantry for participants. The second event is the Late Night Basketball Awards Ceremony. The cost of entertainment is 300.00 for a DJ, and $80.00 to rent outdoor movie screen from City of Phoenix Councilman Michael Norwakowski’s District. The program will budget an additional $700.00 to provide food for awards ceremony serving 500 people. 4. $7,900.00 is the cost of program shirts, jerseys and awards. The Late Night Basketball team works with Thunderbird Trophies. They offer us a low rate of $6.00 dollars per camp shirt, and $15.00 dollars per tournament jersey. Program will order 250 camp shirts and 280 tournament jerseys. The cost for participation medals for skills camp is $4.00 per medal and the cost for trophies for 60 tournament winners and slam dunk competition is $20.00 per trophy. 5. $8,500.00 is the cost for game officials. During the Holiday Class, Late Night round robin tournament, and championship games we expect a total of 73 games. The cost of two official per/game is $110.00 6. 1,875.00 is the quoted cost of branded basketballs for the Late Night Basketball Skills Camp. The cost per/ball is $7.5 Gila River Indian Community Grant Application Grant Cycle 2016 7. $870.00 is the cost for supplies needed for the program. The program will need to purchase 2 basketball score books for $20.00, 2 first aid kits, and spend $500.00 for printing of promotional materials. The program will also need markers, printer ink, and paper for basketball skills camp registration table ($150.00). The program will use an additional $200.00 for photography of championship games. 8. $1640.00 is the total cost estimate for food at the championship games and tournament games. While at the Talking Stick Arena the Late Night Basketball program is required to purchase lunch from arena corporate sponsors. Last year we were quoted $489.00 dollar to cater lunch for 300 camp participants. Program will spend an addition $140 dollars on fresh fruit for championship game participants and snacks for skills camp. The budget includes in-kind contributions from the St. Mary Food bank to feed basketball teams after games during August tournament. Food from the St. Mary’s Food bank must be eaten in the Grant Park gym. 9. $2000.00 is the total in-kind contribution of Gatorade and water from Pepsi-Co. 10. $1,800.00 is the total cost of program insurance necessary to fulfill City of Phoenix Policy. This quote is from Estrella Insurance Company. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. Created: 02/08/2016 Last updated: 02/09/2016 Page 1 General information Organization Southwest Human Development Contact First name Lisa Contact Last name Olivas-Cook Contact e-mail grants@swhd.org Contact phone number 602-633-8178 Address Street 2850 N 24th St City Phoenix State AZ ZIP Code 85008 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request 100000 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program from the Gila River Indian Community, enter the amount to be requested each year. Amount Year 1 (Gila River Indian Community Grants Only) 100,000 Year 2 (Gila River Indian Community Grants Only) Year 3 (Gila River Indian Community Grants Only) Year 4 (Gila River Indian Community Grants Only) Year 5 (Gila River Indian Community Grants Only) 1 of 1 Department of tho Treasmry ntornal Revonua Se•rvice P.O. Box 2508 In reply refer to 0248459775 Cincinnati OH 45201 June 16, 2010 LTR 4168C E0 86-0407179 000000 00 00028241 BODC: TE SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH ST PHOENIX AZ 85008-1004 025080 Employer Identification Number: 86-0407179 Person to Contact: MISS CSINSI Toll Free Telephone Number: 1 - 877-829-5500 Dear TAXPAYER: This is in response to your June 07, 2010, request for information regarding your tax-exempt status. Our records indicate that your organization was recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in MAY 1983. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code, Beginning with the organization's sixth taxable year and all succeeding years, it must meet one of the public support tests under section 170(b)(1)(A)(vi) or section 509(a)(2) as reported on Schedule A of the Form 990. If your organization does not meet the public support test for two consecutive years, it is required to file Form 990-PF, Return of Private Foundation, for the second tax year that the organization failed to meet the support test and will be reclassified as a private foundation. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, -riCakk.:7)( Michele M. Sullivan, Oper. Mgr, Accounts Management Operations I Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/26/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County 3. Mayor (City or Town) or Board of Supervisor's Chairman (County): Clint Hickman 4. Mailing Address: 301 W Jefferson, 10t h Floor 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information 7. Department/Organization Name: Southwest Human Development 8. Is this a non-profit 501c(3) Organization? No 2‹ Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Ginger Ward Title: Chief Executive Officer 10. Phone Number: 602 -633 -8178 11. Mailing Address: 2850 N 24th Street 12. City: Phoenix State: Arizona Zip Code: 85008 13. Email Address: grants@swhd.org Website Address: www.swhd.org Project Information 14. Project Name: Early Childhood Initiatives 15. Purpose of Grant: The purpose is three-fold: 1) to provide comprehensive care for young children with feeding disorders (Healthcare); 2) to prevent child abuse (Public Safety); and 3) to promote early literacy (Education). 16. Priority Funding Area HEALTHCARE, PUBLIC SAFETY, EDUCATION 17. Annual amount requested $100,000 18. Number of years that funding is requested One year 19. Total amount requested (annual amount x $100,000 # of years) 20. Has your organization received past 2015 $75,000 / 2012 $150,000 / 2010 $150,000 funding from GRIC? If yes, list each year and amount 21. Geographic area served State of Arizona, primarily Maricopa County For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Office of Special Funding 2016 Grant Application NARRATIVE SECTION Prepared by: Southwest Human Development Briefly describe the organization's mission, history and goals. Founded in 1981, the mission of Southwest Human Development (SWHD) is to strengthen the foundation Arizona's children need for a great start in life. Our vision is a positive future for every child. The agency strives to help children establish a healthy foundation by preventing problems before they arise, or when they already exist, intervening as early and effectively as possible. Recognizing a child's earliest experiences and relationships establish the foundation for all future development, Southwest Human Development's more than 40 comprehensive programs focus on young children — ages birth to 5 — and their families in the areas of child development and mental health, Easter Seals disabilities services, early literacy and Head Start, child welfare, and professional development and training. Learn more at www.swhd.org . 2. If the organization is a non-profit 50143), please describe your relationship with the municipality including past and present support, whether it be through partnership, collaboration, in-kind contributions, grants, tax-based funding or other. If the organization is a municipality governmental sub-division please enter the text "Not applicable." SWHD has a long history of collaboration with a wide range of community partners, and has well-established working relationships with many organizations serving young children and families. Here is a sampling of our engagement with Maricopa County in recent years: O In 2002 our Healthy Families program received a grant of $1,500 from Maricopa County Cooperative Extension. O In 2009 our Emergent Leader program provided training, technical assistance, mentoring and consultation for Maricopa County Early Head Start in toddler classrooms at East Valley Institute of Technology and Compadre High School. • A contract with Maricopa County Superior Court (FY15 & FY16) to present our New Beginnings Program provides support for separating and divorcing/divorced parents, and helps them learn and practice skills to increase positive interactions in the family. • Since 2011 our Smart Support program has had a contract with Maricopa County to provide mental health consultation for Maricopa County Head Start to promote the social and emotional development of all children in care, and to help providers respond to children with behavioral challenges. 3. Describe the proposed project and planned goals and activities. Southwest Human Development proposes a partnership with the Gila River Indian Community to present essential programs for children birth to five years old, and their families. The purpose of this partnership is three-fold: 1) to provide comprehensive care for young children with feeding disorders; 2) to prevent child abuse; and 3) to promote early literacy. Southwest Human Development's one-year, $100,000 request seeks support for three signature programs: Feeding Program for Infants and Young Children, Birth to Five Helpline/Fussy Baby, and Reach Out and Read. Each of these programs is directly aligned with a GRIC funding priority as further described below in Question 4. Page 1 of 10 FEEDING PROGRAM FOR INFANTS AND YOUNG CHILDREN Amount Requested: $50,000 / Use of Funds: GRIC funds will be used to provide Feeding Team assessments or individual feeding therapy sessions/nutrition consultations for families whose children are experiencing feeding difficulties. The goal of the Feeding Program is to provide comprehensive care for young children ages 0-5 with feeding disorders, and to prevent future medical, developmental, and social/emotional problems for this extremely vulnerable population. Services include early identification, assessment, care coordination, and treatment. This program offers a wide range of services for infants and toddlers who have food aversions, difficulty eating, or are unable to eat by mouth. A large number of young children experience significant problems with feeding and swallowing, which can have serious short and long-term consequences for their physical, developmental, and social/emotional well-being. Some children must be tube-fed, and some have such severe reflux that eating becomes painful for them. This can create a major stress for families, interfering with virtually every aspect of daily life. Our Feeding Team, the only one of its kind in Arizona, is comprised of a developmental pediatrician, occupational and speech therapists, a mental health specialist, a psychologist, care coordinators, and a pediatric nutritionist (registered dietician). All have special training and expertise in the area of feeding problems. Unique features of the program are: Focus on early identification, assessment, prevention and treatment. • Team approach: Team members see the family together, and collaborate with them in developing one unified care plan. • Coordination and integration of care: Helps families avoid going from one specialist to another. Supports a holistic view of the child and family. Our developmental pediatrician works closely with the other medical specialists treating the child. • A comprehensive approach: Our team is unique in that it offers a blend of medical, developmental, and mental health expertise. • Cost efficient: Early identification and treatment helps prevent or minimize future problems and costly interventions later on. • Community-based: Our team reaches out to collaborate with therapists and practitioners in the community, and also provides services in the family's home. Early and accurate diagnosis is absolutely critical for a successful outcome for infants and toddlers with feeding problems. Unfortunately, this is often not provided to families in our community. Our current state system does not support a thorough evaluation process. Rather, children are deemed eligible or ineligible for services based on the presence or absence of a specified level of developmental achievement. The underlying causes or origins are not explored, thus it is difficult to determine what the best treatment options might be. For example, an 18 month old who does not yet tolerate solid foods and whose growth is suffering due to lack of adequate nutrition, may have underlying food allergies, or strong sensory aversions to varied textures of food, or overall developmental delay, or may have suffered significant trauma or abuse. Each of these conditions would call for a very different approach to treatment, and so it is imperative that a thorough and complete diagnostic assessment is made available. Page 2 of 10 BIRTH TO FIVE HELPLINE/FUSSY BABY PROGRAM Amount Requested $25,000 /Use of Funds: GRIC funds will support professional staff, thereby maintaining the quality of program services. All Helpline specialists have college degrees, are experienced in early child development, have extensive additional training, and have achieved Fussy Baby Specialist certification from the prestigious Erickson Institute of Chicago. To help Arizona's parents, caregivers, or professionals in the community caring for young children get the answers they need when they need them, SWHD offers the Birth to Five Helpline and Fussy Baby program. In the short term, the program seeks to increase parent/caregiver confidence arid competence by providing accurate, up-to-date information and support from highly trained early childhood professionals. In the long- term, the program seeks to prevent negative outcomes, including abuse, by providing parents the support and encouragement they need in the moment that reduces stress and offers concrete strategies for successful parenting and caregiving. Callers to the Helpline (1-877-705-KIDS (5437)) have immediate access to a caring, highly-trained, early childhood specialist who provides supportive listening and sound information about child development, parenting, and caregiving. Callers have a wide range of concerns about young children including sleep problems, health and nutrition, challenging behavior, feeding and eating, potty training, fussiness, and general child development. Calls last an average of 20 minutes, but there is no predetermined time limit. Calls are answered Monday through Friday from 8:00 am to 8:00 pm. After hours callers can leave a message or inquire through our website (birthtofivehelpline.org ). Messages are responded to during regular operating hours. Bi-lingual assistance in English/Spanish is always available. Sometimes calls are about a baby who cries excessively, is diificult to comfort, and/or has trouble feeding or sleeping. Inconsolable infant crying is a known risk factor for child abuse, including Shaken Baby Syndrome. For parents, a fussy baby is exhausting and frustrating. Therefore, the overall goal of the Fussy Baby Program is to help parents feel more confident in their ability to parent their child, even though they may be having a difficult time in the beginning. Parents can feel isolated during their child's first year and tend to worry about whether they are meeting their child's needs. This program helps them feel understood and not alone with their concerns. All Helpline specialists are trained and certified in the Erickson Institute's Fussy Baby protocol. The specialists work with parents/caregivers to find ways to soothe, care for, and enjoy their baby. They also offer ways to reduce stress while supporting parents in their role. If the specialist believes it necessary and appropriate, in-home visitations are offered to help parents address their issues within their home setting. There may be several phone or in-home contacts over the course of several days or weeks. While phone-in support is available throughout the state, home visitations are only available in Maricopa County at this time due to funding limitations. REACH OUT AND READ Amount Requested: $25,000 / Use of Funds: At a cost of $6.10 per book, GRIC funds will support the purchase and distribution of 4,098 age and developmentally appropriate books to be distributed to low income children through Reach Out and Read Maricopa County, operated by Southwest Human Development. Reach Out and Read is an evidence-based national model promoting the development of early literacy skills in young children. The program's mission is to give young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together. In pediatric offices, books are used as a developmental tool during well-child visits, allowing the pediatrician to observe fine motor skills, language/literacy development, and parent-child interaction. The program has four components: Page 3 of 10 1. Pediatricians are trained by SWHD in strategies to promote literacy in young children. At well child visits, they advise parents on the importance of reading and give them "prescriptions" for reading daily with their child. 2. In literacy-rich waiting rooms, parents and children are exposed to the pleasures and practices of looking at books together. 3. At every well-child visit, children receive a new, developmentally-appropriate book to take home and keep. Over time, children may receive up to 10 books. 4. Gently-used books are made available in the waiting room for sick visits, siblings, and other children to take home and keep. SWHD's Reach Out and Read coordinator provides training for clinic staff, offering the latest research in language and literacy that helps prepare them as literacy ambassadors. The coordinator also offers ideas, materials, and resources to help the clinics create and maintain literacy-rich environments in their waiting rooms, exam rooms, on bulletin boards and in other common areas. These could include informational displays with resources for parents or reading areas with books for children. The coordinator conducts a site visit every quarter and performs the Quality Rating Assessment annually, for a minimum of five visits to every clinic each year. Clinics place new book orders with SWHD, which we deliver to them. Each year SWHD orders, sorts, warehouses and distributes over 160,000 books from national distributors. SWHD also provides gently used books for clinic waiting rooms, received by donation from community supporters. 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. The Feeding Program for Infants and Young Children is aligned with the HEALTHCARE funding priority in that it 1) provides direct patient care and care coordination that improves the well-being of the children served; 2) promotes integration of medical, developmental, and mental health services so as to provide families with comprehensive support; and 3) improves the overall well-being of the families by reducing stress and anxiety related to eating disorders. The Birth to Five Helpline/Fussy Baby program is aligned with the PUBLIC SAFETY funding priority in that it 1) is an early intervention service that addresses parental concerns before abuse occurs, thereby preventing a potential crime; and 2) is an educational program that is widely marketed in the community through a variety of means, thereby promoting public and individual safety. Reach Out and Read is aligned with the EDUCATION funding priority in that it 1) encourages low-income parents to help their children develop early literacy skills that are critical to future academic success; 2) enhances their general knowledge and understanding of how to achieve this; and 3) provides resources to support them in their role as their child's first teacher. 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. FEEDING PROGRAM FOR INFANTS AND YOUNG CHILDREN The target population are infants and toddlers with feeding problems. During the funding period the program will serve approximately 200 children and families. The incidence of young children with feeding problems is high: an estimated 45% of all typically developing children and up to 80% of children with developmental disabilities have difficulties at some point. These may be related to a concurrent medical problem or condition (e.g. an immature central nervous system due to premature birth), developmental Page 4 of 10 disorder (e.g. Autism), or underlying mental health problem (e.g. attachment disorder, trauma or abuse). Children at risk for feeding disorders include: high-risk premature infants; children with cardiac, pulmonary, and neurological problems; and an estimated SO% of children with Autism. Over 50% of parents of premature infants report poor feeding by 6 months adjusted age, and approximately 20% of premature babies qualify for a diagnosis of Failure to Thrive by 8 months adjusted age. Feeding problems are one of the primary reasons for the high-rate of hospital readmission for NICU graduates. This population is underserved, due to Arizona's very restrictive eligibility criteria for early intervention disabilities services, failure to identify and diagnose these problems until later in childhood, restricted access for children living in poverty, lack of care coordination, and limited professional expertise in this area. In addition, families living in Arizona are likely to receive highly fragmented services and do not have the benefit of a trans-disciplinary team process. Furthermore, typical healthcare practice often requires more than one year for accurate diagnosis and treatment planning for a child with a feeding disorder. During this time, children can suffer significant delays in overall growth and development. Disruptions in feeding and swallowing can also negatively affect a child's nutrition, respiratory health, gastrointestinal function, social and emotional growth, and have a lasting impact on parent-child relationships. Early identification and management are critical in supporting a child's best possible growth and development. The Feeding Program is part of Southwest Human Development's Children's Developmental Center (CDC), which serves children with complex developmental disorders. Approximately 25-30% of the 730 families seen through the CDC in 2015 required the services of our Feeding Team specialists. Many of these families are underinsured, and some are uninsured. Typically, insurance does not cover one or more critical services such as dietitian assessment and home programming, or the mental health/behavioral component which can be so important when the parent and child have a long history of struggle and anxiety related to eating. Care coordination is rarely a covered service, and yet is essential in assuring that all providers and team members work together to develop a comprehensive and well-integrated approach to assessment and treatment. BIRTH TO FIVE HELPLINE/FUSSY BABY PROGRAM The target population are Arizona parents, caregivers, or professionals in the community caring for young children. Unrealistic expectations are identified as a risk factor for harsh parenting and child abuse, while greater knowledge of child development is associated with more sensitive parenting and children with fewer behavior problems. Prevent Child Abuse America reports that education and support programs for parents are integral to preventing and breaking cycles of violence. The First Things First Family and Community Survey (2009), makes it clear that Arizona parents are concerned with their child's development and can benefit from more, better, and readily accessible information. Parenting based on understanding age- appropriate emotional, social, cognitive, and language development is most effective and best prepares all children for success in school and later in the workplace and community, During the grant period we project the Helpline/Fussy Baby specialists will respond to about 5,300 calls, and will provide 6,000 hours of individualized, professional consultation and support. As a useful supplement to these reflective conversations, the specialists can mail resources on many topics including developmental stages and milestones, behavior, safe sleep, bedtime tips, discipline, toilet training, early language and literacy, and suggested book lists. Hundreds of referrals for additional information or services will be made, including child care, health, mental health, disabilities services, crisis intervention, poison control, basic needs such as housing, food and clothing, and much more. SWHD programs the specialists might refer to Page 5 of 10 could include the Children's Developmental Center, Good Fit Counseling Center, Head Start/Early Head Start, Healthy Families, Parent Partners Plus, or Nurse Family Partnership. Other organizations or programs they might refer to could include First Things First, AZ Early Intervention Program, Mercy Maricopa Integrated Care, Maricopa Integrated Health Services, AZ Children's Association, Breastfeeding Helpline, Southwest Autism Research & Resource Center, WIC, libraries, school districts, family resource centers, etc. And they will serve about 65 parents with Fussy Baby phone support, and in home visits in Maricopa County. REACH OUT AND READ Success in school translates into success in life, and the promise of self-sufficiency in adulthood. Many children under age eight face significant barriers to school readiness including poverty, difficulty speaking and understanding English, and lack of exposure to books and other literacy resources. Children from low income neighborhoods, children growing up without books in their homes, children with limited English proficiency, and children whose parents have low literacy skills are particularly vulnerable. Children who enter kindergarten without the skills needed to succeed in school rarely meet the critical milestone of reading proficiently by third grade, a strong predictor of high school graduation. By contrast, children whose parents read to them, tell them stories, talk and sing songs with them develop larger vocabularies, become better readers, and do better in school. During the grant period we project the Reach Out and Read program will serve 90,000 low income families, in partnership with our 71 pediatric clinic partners throughout Maricopa County. 6. Define the project as a new or continuing program. All three are continuing programs of Southwest Human Development. The Feeding Program was established in 2008, the Birth to Five Helpiine in 2005 (with the Fussy Baby component added in 2007), and Reach Out and Read in 1998. All have been in continuous operation since being established. 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. As these are continuing programs, there are no start and finish dates. If awarded, grant funds will be expended within one year of receipt as indicated above in Question 3, and in the budget and budget narrative submitted with this request. 8. Identify other organizations, partners or funders participating in the project and their roles. Southwest Human Development has a blended funding stream that breaks down as follows: 88% Federal, State and First Things First contracts / 4% Program Fees / 4% Contributions/ 3% Donated Goods & Services / 1% Carry Over and Other Revenue. The agency is dedicated to working in collaboration with other agencies and organizations to help ensure that the needs of Arizona's youngest, most vulnerable children are met. The agency looks for unmet needs and, with the community, seeks to develop programs that meet those needs or to bring proven, national models, modified to meet Arizona's unique needs, to the state. Our collaborative partners include First Things First, Easter Seals, American Academy of Pediatrics Arizona Chapter, Arizona Multihousing Association, several school districts, Arizona tribal communities, government entities at the local, state, and national level, and many national programs including Reach Out and Read, Raising A Reader, Healthy Families, Fussy Baby Network, Nurse-Family Partnerships and many others. Program-specific collaborations are as follows: Page 6 of 10 FEEDING PROGRAM FOR INFANTS AND YOUNG CHILDREN The Feeding Program has an extensive network of relationships and partnerships within the community. These include the Arizona Early Intervention Program, the Division of Developmental Disabilities, community therapy providers, many of the area hospitals, newborn intensive care programs, parent advocacy groups such as Raising Special Kids and Feeding Matters, Head Start and Early Head Start, Healthy Families, local school district special education programs, and primary care providers. Feeding Matters, a nationally recognized parent advocacy group, cites our program as a go-to program for young children and families in our community. We have been invited by the Hearing and Speech Program at ASU to help develop a training program for clinicians hoping to serve this population: our staff will help develop and teach the coursework and provide internship placements for their graduate students. As noted, this program is part of our Children's Developmental Center, with revenue that breaks down as follows: 58% State Age ncy Contracts! 7% Insurance Reimbursement / 1% Private Pay / 34% Contributions. BIRTH TO FIVE HELPLINE/FUSSY BABY PROGRAM The Helpline/Fussy Baby program is the only program of its kind in Arizona. Its success is enhanced by its many collaborations in the community. These include the national Fussy Baby Network®, First Things First, Prevent Child Abuse Arizona, Arizona Chapter of the American Academy of Pediatrics, Association for Supportive Child Care, local employers and military partners who promote the program as a benefit, and many others. The program is a vital community resources, and is broadly marketed throughout the state. Information is distributed as brochures and magnets, in English and Spanish, through hospitals, pediatricians' offices and clinics, Head Start centers, through community outreach activities, and in new parent kits that accompany every newborn home from the hospital. The program's funding breaks down as follows: 34% First Things First contract! 26% Fee for Service (consultation, training, sponsorships, pediatric partnering)! 50% Contributions. REACH OUT AND READ We work closely with the American Academy of Pediatrics Arizona Chapter, through which the Reach Out and Read Arizona Coalition is incorporated. Southwest Human Development is the designated operator of Reach Out and Read Maricopa County. Our primary collaborators in the program are the 71 participating pediatric clinics throughout the county. The providers who deliver the program are volunteers who participate because they want the very best outcomes for their young patients. We also work in partnership with Read On Arizona, a statewide, public/private partnership of agencies, philanthropic organizations, and community stakeholders committed to creating an effective continuum of services to improve language and literacy outcomes for Arizona's children from birth to eight. Through this partnership strategies are being created by building a network of communities developing a literacy system focused on language-rich and engaging programs, ongoing screenings and assessments, and family supports. Reach Out and Read has been identified as a program that can effectively develops and strengthens literacy and language acquisition in the earliest phases of the learning continuum (birth-5). During the grant period we project Reach Out and Read will serve 90,000 low income children throughout Maricopa County, with program funding that breaks down as follows: 8% First Things First contract / 15% Clinic Billings! 77% Contributions. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? Given the breadth, depth and impact of the proposed partnership, SWHD is hopeful the GRIC will support this proposal at the level requested, although each of the programs would be able to operate with partial funding. Page 7 of 10 FEEDING PROGRAM FOR INFANTS AND TODDLERS As stated in Question 3, GRIC funds will be used to provide Feeding Team assessments or individual feeding therapy sessions/nutrition consultations for families whose children are experiencing feeding difficulties. A Feeding Team Assessment costs approximately $1,430 and includes the intake visit, medical record review, team assessment, report, home program, and care-coordinal ion/follow-up. The team is comprised of a developmental pediatrician, occupational and/or speech therapist, feeding specialist, psychologist, care coordinator, and dietitian. Individual feeding therapy sessions/nutrition consultations cost approximately $120 each, and an individual child and family may require from 10 to 24 individual sessions. A grant award at any level will be used for this purpose. BIRTH TO FIVE HELPLINE/FUSSY BABY PROGRAM The total program budget is $291,825 of which $239,127 (81%) represents salaries and benefits. As stated previously, the Helpline specialists are highly educated, trained and experienced early childhood professionals who ensure the program offers the highest level of knowledge, support and guidance for the parents/caregivers calling. A grant award at any level will be used for this purpose. REACH OUT AND READ During the grant period we will buy 90,000 books to be given to that many low income children, at a projected cost of $129,750. The participating clinics are projected to pay $45,000 (35%) as their financial contribution, for a balance of $84,750 in other funding needed. The requested $25,000 represents 29% of that remaining balance, and would supports the purchase and distribution of 4,098 books to low income children. A grant at any level will be used for this purpose. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. While SWHD has an operating budget of over $63 million, 88% of that represents federal, state and First Things First contracts for targeted programs and services, primarily Head Start and Child Welfare. By comparison, the budgets for the three proposed programs represent less than 1% each of the agency's overall budget, with substantial portions of program revenue raised through philanthropy (34% for the Feeding Program, 50% for Helpline/Fussy Baby, and 77% for Reach Out and Read). SWHD practices a robust and comprehensive fund development plan that include individual giving, direct mail, special events, corporate, foundation, and CDBG grant seeking, sponsorships, community outreach, and volunteer engagement. Your support is vital to maintaining these services for Arizona. 11. Describe your plan to document progress and results. Southwest Human Development is committed to ongoing program evaluation. As a state and federally funded and licensed organization, the agency meets rigorous quality performance standards. All agency programs, whether publicly or privately funded, have an evaluation component to measure progress and outcomes; this information is used to make program modifications as needed. SWHD routinely relies upon objective outside evaluators to develop and implement new program evaluation tools. Page 2 of 10 FEEDING PROGRAM FOR INFANTS AND TODDLERS Targeted outcomes include the following: O Number of trans-disciplinary Feeding Team evaluations completed. 6 Number of Feeding Therapy treatment sessions provided. O Average % of individual child/goal outcomes met during course of Feeding Therapy treatment. • Parent satisfaction survey using 4 point Likert Scale measuring usefulness of assessment/therapy; observed improvement in child's feeding/eating skill development; and sensitivity/responsiveness of clinician to individual needs of the family. BIRTH TO FIVE HELPLINE/FUSSY BABY PROGRAM Identification of strategies parents and caregivers can use to resolve the issues for which they are calling is the primary criteria for success for the Helpline/Fussy Baby Program. This, as well as overall caller satisfaction, is measured through follow-up calls made by a staff person who did not originally field the call. In our most recent survey tabulation, results showed that 98% of callers rated the Helpline as a 4 or 5 on a scale of 1 to 5, with five being the highest level. Callers indicated greater confidence in their parenting as a result of their Helpline call and that they would recommend the Heipline to family and friends. Process evaluation continuously tracks the number of calls to the Helpline/Fussy Baby Program, types of questions, type and number of materials sent and referral sources offered. SWHD's Fussy Baby Program is part of the National Fussy Baby Network, originated and based at the prestigious Erickson Institute in Chicago. SWHD participated in the national network's evaluation protocol, the data from which has shown decreased in maternal depression and parenting stress and increases in maternal self-efficacy for parents who have participated in the program. These changes all have a critical impact on the baby and his or her ability to grow and thrive, and are associated with reductions in the risk of child abuse. Evaluation results are shared quarterly with program staff and managers for the purpose of quality assurance and program improvement. REACH OUT AND READ SWHD's primary goal with Reach Out and Read is to ensure successful implementation of and fidelity to the research-based Reach Out and Read program model within all clinic partners. This ensures reliable national outcome and evaluation results are achieved for the local population. Specific objectives are: 1. Participating pediatric clinics will score at least 20 out of 25 on the Quality Assessment Rating scale completed annually by the Reach Out and Read Coordinator. 2. Participating pediatric clinics will provide one new developmentally-appropriate book to each child at each well-child visit for patients between the ages of 6 months and 5 years. During quarterly site visits, the Coordinator will review the monthly well-child visits reported and clinic book inventory in comparison to SWHD's book distribution records to ensure that each child is receiving a book. Page 9 of 10 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. SWHD submitted applications to the Ft. McDowell Yavapai Nation in 2011, 2014 and 2015, all of which were declined. The chart below represents funding received from other tribes. Tribe Funding Program Date Received Ak-Chin Indian Community $10,000 Reach Out and Read 12/28/10 Salt River Pima-Maricopa Indian Community $20,000 Birth to Five Helpfine 8/27/15 $40,000 Birth to Five Helpline 12/6/10 $5,000 Golf Tournament 9/17/04 $5,000 Good Fit Counseling Center 7/22/03 $5,000 Good Fit Counseling Center 6/20/02 Page 10 of 10 Southwest Human Development, Inc. Budget Period: July 1, 2016 ‐ June 30, 2017 Amount Amount Requested Requested from or Secured from In‐Kind Proposed Budget Expense GRIC Other Funders Contributions Total Budget 1.CDC Feeding Program ‐ Salary $ 50,000 $ 805,020 $ ‐ $ 855,020 2.CDC Feeding Program ‐ Benefits $ ‐ $ 230,855 $ ‐ $ 230,855 3.CDC Feeding Program ‐ Other Professional Services $ ‐ $ 16,700 $ ‐ $ 16,700 4.CDC Feeding Program ‐ Travel $ ‐ $ 2,500 $ ‐ $ 2,500 5.CDC Feeding Program ‐ Mileage $ ‐ $ 20,000 $ ‐ $ 20,000 6.CDC Feeding Program ‐ Cellular Phone Service $ ‐ $ 7,000 $ ‐ $ 7,000 7.CDC Feeding Program ‐ Space Maintenance $ ‐ $ ‐ $ ‐ 8.CDC Feeding Program ‐ Program Supplies $ ‐ $ 4,500 $ ‐ $ 4,500 9.CDC Feeding Program ‐ Office Supplies $ ‐ $ ‐ $ ‐ 10CDC Feeding Program ‐ Training $ ‐ $ 3,000 $ ‐ $ 3,000 11.CDC Feeding Program ‐ License, Dues, Subscriptions $ ‐ $ 2,000 $ ‐ $ 2,000 12.CDC Feeding Program ‐ Other Operating Expense $ ‐ $ ‐ $ ‐ 13.CDC Feeding Program ‐ Agency Overhead $ ‐ $ 114,158 $ ‐ $ 114,158 14.CDC Feeding Program ‐ Postage $ ‐ $ ‐ $ ‐ 15.CDC Feeding Program ‐ Equipment Maintenance $ ‐ $ ‐ $ ‐ 16.CDC Feeding Program ‐ Food $ ‐ $ ‐ $ ‐ 1.Helpline/Fussy Baby ‐ Salary $ 25,000 $ 163,293 $ ‐ $ 188,293 2.Helpline/Fussy Baby ‐ Benefits $ ‐ $ 50,834 $ ‐ $ 50,834 3.Helpline/Fussy Baby ‐ Other Professional Services $ ‐ $ ‐ $ ‐ 4.Helpline/Fussy Baby ‐ Travel $ ‐ $ 3,500 $ ‐ $ 3,500 5.Helpline/Fussy Baby ‐ Mileage $ ‐ $ 3,434 $ ‐ $ 3,434 6.Helpline/Fussy Baby ‐ Cellular Phone Service $ ‐ $ 2,664 $ ‐ $ 2,664 7.Helpline/Fussy Baby ‐ Space Maintenance $ ‐ $ ‐ $ ‐ 8.Helpline/Fussy Baby ‐ Program Supplies $ ‐ $ 14,950 $ ‐ $ 14,950 9.Helpline/Fussy Baby ‐ Office Supplies $ ‐ $ 757 $ ‐ $ 757 10.Helpline/Fussy Baby ‐ Training $ ‐ $ 868 $ ‐ $ 868 11.Helpline/Fussy Baby ‐ License, Dues, Subscriptions $ ‐ $ ‐ $ ‐ 12.Helpline/Fussy Baby ‐ Other Operating Expense $ ‐ $ ‐ $ ‐ 13.Helpline/Fussy Baby ‐ Agency Overhead $ ‐ $ 26,525 $ ‐ $ 26,525 14.Helpline/Fussy Baby ‐ Postage $ ‐ $ ‐ $ ‐ 15.Helpline/Fussy Baby ‐ Equipment Maintenance $ ‐ $ ‐ $ ‐ 16.Helpline/Fussy Baby ‐ Food $ ‐ $ ‐ $ ‐ 1.Reach Out and Read ‐ Salary $ ‐ $ 98,050 $ ‐ $ 98,050 2.Reach Out and Read ‐ Benefits $ ‐ $ 26,474 $ ‐ $ 26,474 3.Reach Out and Read ‐ Other Professional Services $ ‐ $ ‐ $ ‐ 4.Reach Out and Read ‐ Travel $ ‐ $ ‐ $ ‐ 5.Reach Out and Read ‐ Mileage $ ‐ $ 3,337 $ ‐ $ 3,337 6.Reach Out and Read ‐ Cellular Phone Service $ ‐ $ 720 $ ‐ $ 720 7.Reach Out and Read ‐ Space Maintenance $ ‐ $ 6,500 $ ‐ $ 6,500 8.Reach Out and Read ‐ Program Supplies $ 25,000 $ 104,750 $ ‐ $ 129,750 9.Reach Out and Read ‐ Office Supplies $ ‐ $ 480 $ ‐ $ 480 10.Reach Out and Read ‐ Training $ ‐ $ 1,130 $ ‐ $ 1,130 11.Reach Out and Read ‐ License, Dues, Subscriptions $ ‐ $ ‐ $ ‐ 12.Reach Out and Read ‐ Other Operating Expense $ ‐ $ ‐ $ ‐ 13.Reach Out and Read ‐ Agency Overhead $ ‐ $ 25,460 $ ‐ $ 25,460 14.Reach Out and Read ‐ Postage $ ‐ $ ‐ $ ‐ 15.Reach Out and Read ‐ Equipment Maintenance $ ‐ $ ‐ $ ‐ 16.Reach Out and Read ‐ Food $ ‐ $ ‐ $ ‐ Total Budget $ 100,000 $ 1,739,459 $ ‐ $ 1,839,459 Gila River Indian Community Office of Special Funding 2016 Grant Application Project Budget Detail Prepared by: Southwest Human Development Please provide a narrative description for each of the budget line items CDC Feeding Program Budget Line 1: Salary – The total of $50,000 requested for the CDC Feeding Program will go towards staffing of the program and contribute about 1 FTE to the program. Helpline/Fussy Baby Program Budget Line 1: Salary – The total of $25,000 requested for the Helpline/Fussy Baby program will go towards staffing of the program and contribute about .5 FTE to the program. Reach Out and Read Budget Line 8: Program Supplies – The total of $25,000 requested for the Reach Out and Read program will go towards the purchase of 4,098 books at a cost of $6.10 each. Department of tho Treasmry ntornal Revonua Se•rvice P.O. Box 2508 In reply refer to 0248459775 Cincinnati OH 45201 June 16, 2010 LTR 4168C E0 86-0407179 000000 00 00028241 BODC: TE SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH ST PHOENIX AZ 85008-1004 025080 Employer Identification Number: 86-0407179 Person to Contact: MISS CSINSI Toll Free Telephone Number: 1 - 877-829-5500 Dear TAXPAYER: This is in response to your June 07, 2010, request for information regarding your tax-exempt status. Our records indicate that your organization was recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in MAY 1983. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code, Beginning with the organization's sixth taxable year and all succeeding years, it must meet one of the public support tests under section 170(b)(1)(A)(vi) or section 509(a)(2) as reported on Schedule A of the Form 990. If your organization does not meet the public support test for two consecutive years, it is required to file Form 990-PF, Return of Private Foundation, for the second tax year that the organization failed to meet the support test and will be reclassified as a private foundation. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, -riCakk.:7)( Michele M. Sullivan, Oper. Mgr, Accounts Management Operations I Created: 02/08/2016 Last updated: 03/09/2016 Page 1 General information Organization Southwest Autism Research & Resource Center (SARRC) Contact First name Greg Contact Last name Boone Contact e-mail gboone@autismcenter.org Contact phone number 602-218-8213 Address Street 300 North 18th Street City Phoenix State AZ ZIP Code 85006 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request 185,000 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program from the Gila River Indian Community, enter the amount to be requested each year. Amount Year 1 (Gila River Indian Community Grants Only) 92,500 Year 2 (Gila River Indian Community Grants Only) 92,500 Year 3 (Gila River Indian Community Grants Only) Year 4 (Gila River Indian Community Grants Only) Year 5 (Gila River Indian Community Grants Only) 1 of 1 IRS Department of the Treasury Internal Revenue Service In reply refer to: 0248367576 CINCINNATI OH 45999-0038 June 23, 2014 LTR 4168C 0 31-1496646 000000 00 00029552 BODC: TE SOUTHWEST AUTISM RESEARCH AND RESOURCE CENTER 300 N 18TH ST PHOENIX AZ 85006 Employer Identification Number: 31-1496646 Person to Contact: Ms. Yates Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your June 12, 2014, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in March 1997. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. 0248367576 June 23, 2014 LTR 4168C 0 31-1496646 000000 00 00029553 SOUTHWEST AUTISM RESEARCH AND RESOURCE CENTER 300 N 18TH ST PHOENIX AZ 85006 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, e.71- 4. etil,_a, Susan M. O'Neill, Department Mgr. Accounts Management Operations Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/22/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County – Government Relations 3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Clint Hickman 4. Mailing Address: 301 West Jefferson, 10th Floor 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information 7. Department/Organization Name: Southwest Autism Research & Resource Center (SARRC) 8. Is this a non‐profit 501c(3) Organization? No Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Greg Boone Title: Corporate & Foundation Relations Manager 10. Phone Number: 602‐340‐8717 x1467 11. Mailing Address: 300 North 18th Street 12. City: Phoenix State: Arizona Zip Code: 85006 13. Email Address: gboone@autismcenter.org Website Address: www.autismcenter.org Project Information 14. Project Name: Intensive Parent Training for Families Living in Remote or Rural Areas 15. Purpose of Grant: Provide Arizona’s premier evidence‐based training teaching parent/s living in rural or remote areas how to improve social/communication skills and decrease challenging behaviors in children with autism (ASD). 16. Priority Funding Area Education 17. Annual amount requested $92,500 18. Number of years that funding is requested 2 19. Total amount requested (annual amount x $185,000 # of years) 20. Has your organization received past 2014: $150,000 funding from GRIC? If yes, list each year and 2011: $125,000 amount 21. Geographic area served State of Arizona, particularly rural and remote areas For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Grant Cycle 2016 Narrative Please structure your proposal to provide the following information in the order indicated. Provide the narrative in paragraph form in the text field provided. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. Established in 1997, SARRC is the state’s leading nonprofit organization serving individuals with autism spectrum disorder (ASD) and the people who love, care for, and support them. Our mission is to advance research and provide a lifetime of support for individuals with autism and their families. We are one of only eight organizations nationally who support the lifespan of an individual with ASD while conducting our own independent research. Our organizational goal each year is to provide more than 1,100 individualized services through a variety of programs; serve more than 4,000 parents, family members, typical peers and community members; and train more than 2,000 educational and medical professionals. 2. If the organization is a non‐profit 501c(3), please describe your relationship with the municipality including past and present support, whether it be through partnerships, collaborations, in‐kind contributions, grants, tax‐based funding or other. If the organization is a municipality governmental sub‐division please enter the text “Not applicable.” Maricopa County Department of Public Health is an ongoing referral source for all SARRC programs. While the Intensive Parent Training program has never received funding from Maricopa County or its departments, we are supported by Maricopa County Government Relations and Board Supervisor Clint Hickman to submit our application to the Gila River Indian Community. 3. Describe the proposed project and planned goals and activities. Since 2009, SARRC has offered a solution for over 120 families living in remote or rural areas in Arizona who are supporting a young child diagnosed with ASD. In this intensive, one‐week program parents learn how to implement evidence‐based intervention that is effective for improving social communication skills and decreasing challenging behaviors within the context of everyday natural play and home routines. Research conducted in a university setting (Symon, 2002) demonstrated a one‐week training consisting of 25 clinical hours was enough to increase parent implementation of Pivotal Response Treatment (PRT) with their child, and from 2009‐2011 SARRC evaluated the efforts of the same model in a community‐based research project funded by the Organization for Autism Research. We found this model to be critically important for families living in remote or rural areas of the state that may not have access to services, for those on waiting lists for long‐term services, families who have just received the diagnosis, or families who are looking to increase their skills quickly to meet their child’s needs. In the next two‐year period, we expect to serve over 65 families during the two‐year contract period with 50 families coming from remote or rural areas of the state. The Intensive Parent Training week has been established to support the educational needs of parents and children with ASD between the ages of 15 months to 6 years old, and this year we expanding the service to accommodate families with children up to 10 years old. The training week is clinic‐based and Gila River Indian Community Grant Application Grant Cycle 2016 parents attend each day for approximately 3‐5 hours, dependent on the age of their child, while playing with their child in a supported, collaborative coaching model organized by a skilled SARRC clinician. The week also includes formal assessments (Autism Diagnostic Observation Schedule (ADOS) & Vineland Adaptive Behavior Scales) and the results are included in a written reporting detailing the intervention practices taught to the parent, outcome data collected and recommendations that can be shared with teachers, habilitators and other members of the child’s support team in their home setting. Program goals include two measurements taken over the course of the week, with baseline data collected on Monday and continuous data collection throughout the course of the program, ending on Friday. Among the measurements performed, Parent Fidelity measures how well parents implement techniques learned through the program and Child Responsivity determines how many times a child makes appropriate communicative responses when initiated by a parent. According to our program’s historical data since 2009, child responsivity increased an average of 35 percentage points and parent fidelity increased an average of 48 percentage points in the duration of our one‐week intensive training! 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. Our Intensive Parent Training program supports Gila River Indian Community’s priority areas in both education and healthcare for underserved and vulnerable populations. Research and best practice both promote early intervention having significant impact on children with ASD and their ability to improve social, communication and language skills over time – the earlier a child starts intervention/therapy, the better the outcomes later in life. Through the Intensive Parent Training program, parents are given the tools they need to be their child’s interventionist and support their child’s needs long after the program ends. Along with structured guidance from skilled clinicians, parents are educated on the basic principles of Applied Behavior analysis (ABA) and the motivational procedures of PRT to help guide their child to produce positive behaviors. When parents know how to act and educate like a clinician, their child receives consistent hands‐on interventions whether at SARRC, at home or in the community. This is particularly important for families living in remote or rural areas where there is limited access to additional services. 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Around the time SARRC was founded, the incidence of an autism diagnosis was 1 in 500; today it is 1 in 68 and 1 in 64 in Arizona, one of the five states registering our nation’s highest rates. Autism is the fastest‐growing developmental disability in the U.S., causing significant social, communication and behavioral challenges, typically lasting throughout a person’s life and affecting every age group and ethnic/socioeconomic group. More children will be diagnosed with autism this year than with AIDS, diabetes & cancer combined. We are also seeing a growing disparity exist between families that are able to access and pay for services for their children with autism and those that cannot. Advocacy for early identification and intervention matters, but not all families can afford to follow through on what is recommended or do so quickly. This places a greater burden on families, hospitals, school systems and communities over the course of an individual’s lifetime. Our Intensive Parent Training serves the need for an affordable option for families without financial means and/or a qualified service option in their Gila River Indian Community Grant Application Grant Cycle 2016 community. Our proposal includes providing our Intensive Parent Training program to at least 50 families living in remote or rural areas, where weekly or daily drives to SARRC for therapies are not feasible. Sadly, autism services are nonexistent in most of these areas and families have little hope of accessing the clinical therapies their children desperately needs. An attachment has been included showcasing program results and county origin for 36 families (as of 2/12/2016) served under Gila River Indian Community contract (GR‐106‐14, ending June 4, 2016). 6. Define the project as a new or continuing program. Continuing program. Since the program’s creation, SARRC has completed intensive parent training with 126 families as of 2/12/2016. 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. The Intensive Parent Training program operates throughout the year, with scheduled weeks booking months in advance. We are currently working under Gila River Indian Community contract (GR‐106‐14, ending June 4, 2016) with the expectation of serving more than our projected goal of 50 families living in remote or rural areas during the two‐year contract period. We are planning to serve families paying through private pay and/or insurance reimbursement during the months of June‐September while we await the notification from this application. 8. Identify other organizations, partners or funders participating in the project and their roles. As the state’s largest nonprofit provider to the autism community, our program receives a majority of referrals from the Arizona Department of Economic Security’s – Division of Developmental Disabilities. We also promote our program through a vast network of pediatricians, other service providers and additional county/state offices that serve children health‐related needs. To accommodate those with additional financial restrictions, SARRC partners with Ronald McDonald House to refer families for community housing, with access to a community kitchen and nightly‐sponsored dinners by other nonprofits. This opportunity helps SARRC drastically reduce the cost of a family’s stay, in comparison to the cost of hotel accommodations and groceries for the entire week. The Gila River Indian Community is the sole funder for our Intensive Parent Training program. We increase program sustainability by serving families located within the Phoenix metropolitan area who pay through private pay and/or insurance reimbursements. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? In order to serve an additional 50 families living in remote or rural areas of the state, partial funding of $150,000 over the two‐year contract is needed. The additional $35,000 requested for this application will be used to identify, develop and evaluate effectiveness of pre‐ training materials to improve effects on our model and increase fidelity scores, both before training and after program completion. We believe if parents are pre‐trained on the basics of ABA and PRT, they will arrive on Monday with a baseline fidelity measurement of 30% and will successfully reach over 80% upon completing the program on Friday. This increase in fidelity is critical for parents’ ability to act as their child’s clinician upon returning home to their natural setting. Gila River Indian Community Grant Application Grant Cycle 2016 Additionally, a portion of our increased funding will be used to purchase age‐appropriate play materials for the toddlers and school‐aged children we are expanding service to in the program. Many of the play materials used in our trainings are effective educational tools and often unknown to our parents’ upon their arrival. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. Within our current grant cycle (ending June 4, 2016), SARRC has made significant strides toward financial diversification and sustainability for the Intensive Parent Training program. As we expect to serve 50 families from remote or rural areas over the two‐year grant period, we have also completed training with 11 families living within the Phoenix metropolitan area, who paid through private pay and/or insurance. While there is no cost for a remote or rural families to attend the training under the GRIC contract, a fee of $2,250 is charged for the program for those living within the Phoenix metro. These training weeks continue to serve the increase need for the program while diversifying our revenue streams and sustaining our program over time. 11. Describe your plan to document progress and results. A major component of our clinical model is to observe and measure progress to determine whether the parent/s learn how to implement Pivotal Response Treatment (PRT) during the one‐week program. Our staff continually tracks success of implementation using a Parent Fidelity measure and Child Responsivity measure. As a previously awarded organization, we are well versed in the reporting requirements needed by the Gila River Indian Community. We are proud to share the progress and transformation families go through while completing the Intensive Parent Training program. With this request, we seek to expand the effectiveness of our model and will diligently report on the value pre‐training materials bring to the program and families served by increasing fidelity scores pre/post training. 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. SARRC has not previously requested funds at any time from any other Tribe other than Gila River Indian Community for state shared revenues for this program. Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: 10/1/2016 – 09/30/2017 For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Salaries & Fringe Benefits $ 62,800 $ 20,150 $0 $ 82,950 2. Materials & Supplies $ 15,000 $ 6,200 $0 $ 21,200 3. Marketing $ 2,500 $ 2,500 $0 $ 5,000 4. Occupancy & Communication $ 2,200 $ 1,650 $0 $ 3,850 5. Direct Client Assistance $ 10,000 $0 $0 $ 10,000 6. Amortization & Depreciation $0 $ 4,750 $0 $ 4,750 7. Administrative Overhead Alloc. $0 $ 14,850 $0 $ 14,850 8. Click here to enter text. $0 $0 $0 $0 9. Click here to enter text. $0 $0 $0 $0 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $ 92,500 $ 50,100 $0 $ 142,600 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: 10/1/2017 – 09/30/2018 For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Salaries & Fringe Benefits $ 62,800 $ 21,800 $0 $ 84,600 2. Materials & Supplies $ 15,000 $ 6,450 $0 $ 21,450 3. Marketing $ 2,500 $ 2,500 $0 $ 5,000 4. Occupancy & Communication $ 2,200 $ 1,740 $0 $ 3,940 5. Direct Client Assistance $ 10,000 $0 $0 $ 10,000 6. Amortization & Depreciation $0 $ 4,920 $0 $ 4,920 7. Administrative Overhead Alloc. $0 $ 16,090 $0 $ 16,090 8. Click here to enter text. $0 $0 $0 $0 9. Click here to enter text. $0 $0 $0 $0 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $ 92,500 $ 53,500 $0 $ 146,000 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Detail Please provide a narrative description for each of the project budget items listed on the previous page. Include the dollar figure and how it was derived. 1. Salaries & Fringe Benefits ($62,800 request to GRIC of $82,950 total program budget): Includes the following staff supporting our Intensive Parent Training program: 1 FTE – Clinical Interventionist III ($52,015); .25 FTE – Program Manager ($13,660); .15 FTE – Clinical Manager ($9,225); .15 FTE – Clinical Trainer ($8,050). Each of our staff members hold a Bachelor’s and Master’s Degree in either Psychology, Education, Special Education or Human Development. The program’s managers and trainer hold a Board Certified Behavior Analyst® (BCBA) certification. Merit and cost of living increases have been taken into account for the 2017/2018 budget. 2. Materials & Supplies ($15,000 request to GRIC of $21,200 total program budget): Includes training materials and educational toys used throughout the training week ($6,200). Our request to GRIC includes additional costs related to the development of pre‐training materials ($10,000) and appropriate educational toys for toddlers and school‐aged children ($5,000). 3. Marketing ($2,500 request to GRIC of $5,000 total program budget): Development and outreach of flyers used to promote our program with referral sources 4. Occupancy & Communication ($2,200 request to GRIC of $3,850 total program budget): Based on allocated percentage of time/staff working under program 5. Direct Client Assistance ($10,000 request to GRIC of $10,000 total program budget): Reimbursement for families living in remote or rural areas for accommodations and meals during their training week. Projected to serve 25 families during each contract year, up to $400 per family. 6. Amortization & Depreciation: Based on allocated percentage of staff working under program 7. Administrative Overhead Allocation: Based on allocated percentage of staff working under program 8. Click here to enter text. 9. Click here to enter text. 10. Click here to enter text. 11. Click here to enter text. Gila River Indian Community Grant Application Grant Cycle 2016 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. 2014‐2016 Intensive Parent Training for Families Living in Remote or Rural Areas (through 2/12/16) Program Participants Child Child Parent Fidelity Parent Fidelity Responsivity Responsivity of of Day 1 Day 5 Implementation Implementation (average) (average) Day 1 (average) Day 5 (average) Intensive 34 24 53 17 73 Parent Training (25 hours) Intensive 2 5 73 20 84 Parent Training (15 hours) All 36 23 54 17 73 Intensive Parent Training GRIC Participant Outcomes 2014‐2016 100 90 80 73 70 60 54 Percent 50 Day 1 40 Day 5 30 23 17 20 10 0 Child Responsivity Parent Fidelity GRIC County Families 2014‐2016 GRIC Families Served Served Cochise 2 Cochise Coconino 2 2 Coconino 7 2 Gila 1 1 Gila Graham 2 2 Graham La Paz 1 1 2 La Paz Maricopa 10 Maricopa Mohave 2 Navajo 1 5 Mohave Pima 1 10 Navajo Pinal 5 1 1 Pima 2 Yavapai 2 Pinal Yuma 7 **Maricopa County includes remote or rural areas outside of the Phoenix metropolitan area Last updated: 02/10/2016 Page 1 General information Organization Tumbleweed Center for Youth Development Contact First name John Contact Last name Rubino Contact e-mail jack_rubino_2000@yahoo.com Contact phone number 6025109959 Address Street 3707 N. 7th Street City Phoenix State Arizona ZIP Code 85014 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request 100,000 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program from the Gila River Indian Community, enter the amount to be requested each year. Amount Year 1 (Gila River Indian Community Grants Only) Year 2 (Gila River Indian Community Grants Only) Year 3 (Gila River Indian Community Grants Only) Year 4 (Gila River Indian Community Grants Only) Year 5 (Gila River Indian Community Grants Only) 1 of 1 IRS Rn te vo ef nthuee Tsreeralsiucr)e, Internal Dei a e In reply refer to: 0248164840 CINCINNATI OH 45999-0038 Mar. 25, 2014 LTR 41680 0 23-7284153 000000 00 00021486 BODC: TE TUMBLEWEED CENTER FOR YOUTH DEVELOPMENT 3707 N 7TH ST STE 305 PHOENIX AZ 85014 014347 Employer Identification Number: 23-7284153 Person to Contact: Mrs. Dudley Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Mar. 14, 2014, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in MARCH 1974. Our records also indicate that you are not a private foundation t within the meaning of section 509(a) of the Code because you are descri bed in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Altua,„_, Pia, Susan M. O'Neill, Department Mgr. Accounts Management Operations Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/28/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County 3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Clint Hickman 4. Mailing Address: 301 W. Jefferson Street 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information 7. Department/Organization Name: Tumbleweed Center for Youth Development 8. Is this a non-profit 501c(3) Organization? No Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Jack Rubino Title: Volunteer Grant Writer 10. Phone Number: 602-510-9959 11. Mailing Address: 3707 North 7th Street 12. City: Phoenix State: Arizona Zip Code: 85014 13. Email Address: Jack_Rubino_2000@yahoo.com Website Address: Click here to enter text. Project Information 14. Project Name: Tumbleweed Emergency Housing Program for Homeless Youth 15. Purpose of Grant: Provide short term (up to 90 days) housing for homeless youth 16. Priority Funding Area Public Safety 17. Annual amount requested $100,000 18. Number of years that funding is requested 1 19. Total amount requested (annual amount x # of $100,000 years) 20. Has your organization received past funding Yes, Tumbleweed received $34,000 in 2015 to support the from GRIC? If yes, list each year and amount Emergency Housing Program. For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Grant Cycle 2016 21. Geographic area served Maricopa County Gila River Indian Community Grant Application Grant Cycle 2016 Narrative Please structure your proposal to provide the following information in the order indicated. Provide the narrative in paragraph form in the text field provided. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. Tumbleweed is Arizona’s champion for homeless and forgotten youth. Since its founding by the Soroptomist International of Phoenix in 1972, Tumbleweed has developed an unparalleled family of Emergency Support, Housing Solutions, and Lifelong Success programs offering nearly 1,600 vulnerable youth an unbroken pathway from homeless to self-sufficiency each year. More than half of these young people were abused as children, a trauma which is compounded by violence, fear, and exploitation from living on the streets. Tumbleweed’s Emergency Support programs offer a safety net for these youth including emergency shelters for teens and young adults, 200 community-based “Safe Places” for teens in crisis, two drop-in Youth Resource Centers, and street outreach teams that build trust with the local homeless populations and provides them information about and access to Tumbleweed’s full continuum of programs. Permanently ending youth homelessness requires much more than emergency support, however. Tumbleweed’s Housing Solutions provide the safe supported housing, skill development, and guidance these young people need to leave the streets for good. Housing Solutions include the semi-independent Young Adult Program apartment community where homeless teens and their young children live safely while preparing for adulthood; as well as community based Supported Transitional Apartments, Resources and Training (START) housing program for homeless young adults. Tumbleweed’s Lifelong Success programs include academic re-entry through on-site high school and high school equivalency (GED) programs; structured work readiness and employability skills training; opportunities for paid training through community internships and Tumbleweed’s Youth-In-Business social enterprise, TumbleTees; along with a comprehensive menu of skills programs. 2. If the organization is a non-profit 501c(3), please describe your relationship with the municipality including past and present support, whether it be through partnerships, collaborations, in-kind contributions, grants, tax-based funding or other. If the organization is a municipality governmental sub-division please enter the text “Not applicable.” Gila River Indian Community Grant Application Grant Cycle 2016 Tumbleweed has been serving Maricopa County youth for over 40 years. We work closely with both the county and individual cities in order to provide a full continuum of services for homeless youth. Tumbleweed participates in the Maricopa Association of Government’s Continuum of Care including having a representative on their subcommittee on homelessness. Tumbleweed’s staff engage in multiple taskforces and committees at both the county and city level. Tumbleweed has grants and contracts with several cities in the county including Phoenix, Chandler, Surprise, Peoria, and Scottsdale. 3. Describe the proposed project and planned goals and activities. The goal of this grant is to continue funding Tumbleweed’s Emergency Housing Program. The Emergency Housing Program was started last year and currently maintains 28 beds for emergency housing for homeless youth ages 18-25. The program has been at or near capacity since inception which clearly indicates a great need for this service in Maricopa County. Despite the obvious need for the program, the Emergency Housing Program lacks natural funding and many foundations do not support this age group. This program provides an essential service that will help end youth homelessness in Maricopa County and is asking Gila River Indian Community to partner with us in this effort. Potential participants for the Emergency Housing Program are identified by Tumbleweed through its Street Outreach efforts or case worker interaction with youth who come into our two Youth Resource Centers (Tempe and Phoenix) for services. Typically our participants are involved in the Emergency Housing Program for an average of 30 days and are allowed to stay up to 90 days in certain cases. The Emergency Housing Program provides these street-dependent youth with a safe environment in which they can take necessary steps towards stability and self-sufficiency. The Emergency Housing Program provides the only emergency housing that is specifically designed for youth in Maricopa County. This program has been integrated into Tumbleweed’s continuum of care which provides youth not only a safe place for the night and their basic needs met, but also connects them to programming that supplies case management, housing navigation, and other community resources. In the upcoming year, we predict that the shelter will continue to function with all 28 beds full most nights and, therefore, Tumbleweed’s Emergency Housing Program expects to run at a 98% capacity with the number of unduplicated youth leveling out at around 270. In total, we plan to provide 9,878 bed nights next year. As this is an on-going program, the funds from the grant will go to sustain existing budgets to ensure stability for the Emergency Housing program. 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. Gila River Indian Community Grant Application Grant Cycle 2016 The Emergency Housing Program satisfies the Public Safety priority funding area of the Gila River Indian Community because the Emergency Housing Program enables vulnerable youth to find respite from the streets immediately for their own safety and the safety of the public. (See below for more information on the needs/programs sought to be solved by the Emergency Housing Program.) 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Tumbleweed promotes safety, stability and well-being for youth and young adults who have runaway, are homeless, and have experienced or been exposed to violence, neglect or trauma. Last year, Tumbleweed served nearly 1,600 youth in its programs and reached out to over 2,500 youth through street outreach. Of the youth in Tumbleweed’s programs, 58% were between the ages of 18 and 25. When compared to the prior year, Tumbleweed experienced a 20% increase in unduplicated youth served through our Youth Resource Centers, a 63% increase in the overall number of visits to the Youth Resource Centers, and a 139% increase in the number of street-based contacts with homeless youth made by our Street Outreach Teams. Together, the Street Outreach and Youth Resource Centers represent the most common points of entry for service for homeless young adults in this age range. Despite the growing prevalence of homelessness at this young adult age, these older youth typically fall outside our community’s safety net. Data confirms the long held belief that this population is often emotionally unprepared to navigate complex adult services and can be fearful or mistrustful of adult services targeting the chronically homeless. Research consistently demonstrates that young people living on the streets are at high risk of violence, exploitation, substance abuse, and incarceration. Few are willing to utilize adult shelter resources and, without this critical bridge to transitional housing resources and ultimately self-sufficiency, homeless young people are at profound risk of prolonged experiences of chronic homelessness throughout adulthood. The overburdening of traditional adult shelter systems is complicated by young people’s perceptions of these shelter environments. Most youth are unwilling to utilize adult shelters out of fear for their safety or perceptions that they will not be understood. Local and national data support youth’s concerns that they are at increased risk of victimization, exploitation, and theft in traditional shelter environments commonly used by older chronically homeless individuals. Tragically, many young people will report that they feel safer on the streets or outside than in a mainstream adult shelter. Providing shelter specific to this age group is essential to engaging these young adults in their own path toward self-sufficiency and to ensure their safety while they do so. The Emergency Housing Program currently has 28 beds and runs at or near capacity every night. If the community is serious about eradicating youth homelessness, it is essential to provide unique and specialized services for this vulnerable age group. The Emergency Program is one such program and we invite Gila Rive Indian Community to support these youth in their path toward stability and self-sufficiency. Gila River Indian Community Grant Application Grant Cycle 2016 6. Define the project as a new or continuing program. Emergency Housing is a project that Tumbleweed started in 2014. The Gila River Indian Community funding will help continue to sustain the program. 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. The funds will go to program operating cost over a twelve month period. 8. Identify other organizations, partners or funders participating in the project and their roles. There is a private family foundation that enabled the startup of Emergency Housing Program last year and which will continue supporting but at a lower level. In addition, the following funders have provided support for the Emergency Housing Program: Nina Mason Pulliam Foundation, Valley of the Sun United Way, and Tempe City Council. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? Yes. Tumbleweed can modulate the number of Emergency Housing Program beds it makes available in order to accommodate partial funding. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. The private family foundation that enabled Tumbleweed to initiate Emergency Housing Program in 21014 has indicated its willingness to remain a funder but has requested that Tumbleweed seek additional support from funders like the Gila River Indian Community. 11. Describe your plan to document progress and results. Gila River Indian Community Grant Application Grant Cycle 2016 Long term outcomes for the community include a decrease in the number of homeless youth and an increase in the safety of those youth. Outcomes are aligned with Maricopa Association of Governments’ (MAG) goals to end homelessness through the addition of shelter beds for youth, with target goals to move youth into appropriate stable housing after increasing income through employment (mainstream benefits) and increase self-sufficiency for youth in the program. Through services provided, youth establish permanent connections with caring adults and peers that help them create a sense of value and belonging, as well as a sense of control. It is our experience that having achieved that, street-dependent youth are able to follow through with utilizing mainstream benefits, becoming job-ready, and accessing housing. Measurable outcomes for the upcoming year include: Activities or Outputs % to be achieved Quantitative Counts Bed nights provided 98% occupancy, of 28 beds or 9,878 9,878 available bed count Intake – unduplicated youth 40% <30 days, 30% 31-60 days, 30% 61- 270 90 days Youth completing entry/exit plans 90% of 270 youth 243 Youth were connected to community 75% of 270 youth 203 resources/mainstream benefits Youth gain employment 20% of 270 youth 54 Youth exit to safe places 60% of 270 youth 162 Life-skills workshops offered Workshops offered 70% of the days or 5 256 workshops per week Tumbleweed uses our Homelessness Management Information Systems (HMIS) to track youth in all our programs. In addition, all of the above outputs and outcomes will be tracked through our own agency-wide software. 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. Salt River Pima Maricopa Indian Community $40,000 for the Safe Place Program Tohono O’odham $10,000 for Youth Healing Circles Gila River Indian Community Grant Application Grant Cycle 2016 Yavapai $10,000 Youth Healing Circles Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: 2016-2017 For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget requested from requested or contributions (list each budget item) GRIC secured from other funders 1. Supplies $2000 $194000 $0 $196000 2. Telephone $2000 $88000 $0 $90000 3. Rent and Utilities $50000 $1104518 $0 $1154518 4. Development & Admin Costs $0 $0 $0 $0 5. Direct Assistance to Youth $46000 $168000 $0 $214000 6. Click here to Click here to $0 Click here to enter text. enter text. enter text. 7. Click here to enter text. $0 $0 $0 $0 8. Click here to enter text. $0 $0 $0 $0 9. Click here to enter text. $0 $0 $0 $0 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $100000 $0 $0 $0 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Detail Please provide a narrative description for each of the project budget items listed on the previous page. Include the dollar figure and how it was derived. 1. Supplies: This item covers direct expenses for the program such as printer paper and toner, cleaning supplies and other such items consumed directly by EHP. 2. Telephone: This expense covers the costs associated with conducting EHP including cells phones for Tumbleweed staff to enable them to communicate as they move around Maricopa County. 3. Rent and Utilities: Expenses for 25% of the 28 beds in the EHP are covered by this element of cost. 4. Development & Admin Costs: This element of costs covers EHP cost to run this program and raise funds for its on-going needs. 5. Direct Assistance to Youth: This element of cost covers assistance to youth in the form of bus passes, child care, clothing, hygiene kits, and blankets. 6. Click here to enter text. 7. Click here to enter text. 8. Click here to enter text. 9. Click here to enter text. 10. Click here to enter text. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Gila River Indian Community Grant Application Grant Cycle 2016 Other explanation: See separate attachment for complete Tumbleweed Operational and Emergency Housing Budget. Operational and Emergency Housing Program Budget INCOME Source 2014-2015 2015-2016 Organization Budget GRIC Budget Government Contracts and Grants $77,101.00 $79,414.03 $5,363,616.00 $- Foundations $271,382.00 $279,523.46 $1,184,778.00 $100,000.00 Corporations $- $- $150,000.00 $- United Way or other Federated Campaigns $- $- $25,000.00 $- Individual Contributions $- $- $130,000.00 $- Board Members' Contributions $- $- $20,000.00 $- Fundraising Events $- $- $150,000.00 $- Earned Income $- $- $641,376.00 $- Miscellaneous Income $- $- $5,000.00 $- TOTAL INCOME $348,483.00 $358,937.49 $7,669,770.00 $100,000.00 EXPENSES Item 2014-2015 2015-2016 Organization Budget Organization Budget Salaries and Wages $209,525.00 $215,810.75 $3,827,552.00 $- ERE's (Employee Related Expenses) $40,360.00 $41,570.80 $733,541.00 $- Consultants and Professional Fees $16,985.00 $17,494.55 $246,611.00 $- Subcontractors $- $- $201,259.00 $- Employee Education $- $- $15,000.00 $- Travel/Transportation $15,126.00 $15,579.78 $121,631.00 Equipment $3,537.00 $3,643.11 $68,100.00 $- Supplies $5,509.00 $5,674.27 $196,000.00 $2,000.00 Printing and Copying $74.00 $76.22 $9,000.00 $- Telephone $7,003.00 $7,213.09 $90,000.00 $2,000.00 Postage and Delivery $67.00 $69.01 $7,000.00 $- Rent and Utilities $87,139.00 $89,753.17 $1,154,518.00 $50,000.00 <--$42K rent + $8K utilities Insurance $- $- $56,226.00 $- Depreciation $8,971.00 $9,240.13 $140,000.00 $- Inkind $- $- $- $- Development & Administration $25,705.24 $26,476.40 $342,097.00 $- Direct Assistance to Youth and Families $9,165.00 $9,439.95 $214,000.00 $46,000.00 <--$40K food + $6K supportive services Cost of Goods & Services Provided $- $- $242,235.00 $- Miscellaneous Fees & Expenses $30,388.76 $31,300.42 $5,000.00 $- TOTAL EXPENSES $459,555.00 $473,341.65 $7,669,770.00 $100,000.00 Difference $(111,072.00) $(114,404.16) $- $- Created: 02/16/2016 Last updated: 03/09/2016 Page 1 General information Organization Shun the Sun Foundation, Inc. Contact First name Mario E Contact Last name Diaz Contact e-mail mario@medandassociates.com Contact phone number (623) 217-4484 Address Street 3033 North Central Avenue Suite 445 City Phoenix State AZ ZIP Code 85012 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request 15,000 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program from the Gila River Indian Community, enter the amount to be requested each year. Amount Year 1 (Gila River Indian Community Grants Only) 3,000 Year 2 (Gila River Indian Community Grants Only) 3,000 Year 3 (Gila River Indian Community Grants Only) 3,000 Year 4 (Gila River Indian Community Grants Only) 3,000 Year 5 (Gila River Indian Community Grants Only) 3,000 1 of 1 exempt Please letter. a as or tax under exempt We Dear MESA, 2158 C/O SHUN Date: P. Charities, public either Organizations regarding 2522 deductible are AZ N ROBERT THE CINCINNATI, 0. INTERNAL for see charity your the of deductible section status pleased Applicant: 85203 GILBERT L SUN AUG 2508 BOX organization. some enclosed public exempt under 501(c) we to RD PACKARD 10 OH REVENUE under charities exempt Code. bequests, section (3) have inform STE FOUNDATION 2012 45201 SERVICE helpful Publication the under status, Because 170 of determined you 117 INC Code or section you this devises, of the that information 4221-PC, section(s) private should letter the Internal that upon about 501(c)(3) keep transfers Code. are you review No Addendum Yes June Effective Yes Form Public Accounting (877) Contact ANGELA Contact DLN: Employer compliance listed foundations. of it could or You Revenue of Contribution 22, 990 December M 17053178314041 27-0877642 your in the in help gifts are Code. exempt your Applies: 2011 Date Required: 170(b)(1)(A)(vi) Charity 31 Period 829-5500 Telephone BENDER Person: Guide the We Code your resolve under also from of Status: Identification responsibilities for heading determined are permanent qualified Contributions Federal application Deductibility: Exemption: Ending: Number: DEPARTMENT Letter further any section 501(c)(3) of that to for Number: OF 947 as this records. questions 2055, to income tax ID# THE (DO/CG) an Public you classified 2106 receive you tax 31162 TREASURY are are Gila River Indian Community Grant Application Grant Cycle 2016 Cover Sheet Municipality Information 1. Date of Application: 2/25/2016 (NOTE: Click or use up/down arrow keys to move among fields) 2. Name of City, Town or County: Maricopa County 3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Clint L. Hickman 4. Mailing Address: 301 W Jefferson, 10th Floor 5. City: Phoenix State: Arizona Zip Code: 85003 6. Acknowledgement of Submission by Authorized Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information 7. Department/Organization Name: Shun the Sun Foundation 8. Is this a non-profit 501c(3) Organization? No Yes If yes, attach IRS Determination Letter 9. Application Contact Person: Haley Sitterud Title: Director of Events and Programs 10. Phone Number: (480) 699-2222 x313 11. Mailing Address: 7233 E Baseline Rd #126 12. City: Mesa State: Arizona Zip Code: 85209 13. Email Address: shunthesunfoundation@gmail.com Website Address: shunthesunfoundation.org Project Information 14. Project Name: Protecting Children from Skin Cancer 15. Purpose of Grant: To provide shade structures to schools, parks and playgrounds. 16. Priority Funding Area Healthcare 17. Annual amount requested $3,000 18. Number of years that funding is requested 5 19. Total amount requested (annual amount x # of $15,000.00 years) 20. Has your organization received past funding No from GRIC? If yes, list each year and amount For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Grant Cycle 2016 21. Geographic area served East Valley of Maricopa County Gila River Indian Community Grant Application Grant Cycle 2016 Narrative Please structure your proposal to provide the following information in the order indicated. Provide the narrative in paragraph form in the text field provided. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. Shun the Sun is dedicated to the education and prevention of skin cancer. The foundation utilizes proceeds to build shade structures at schools, parks, and playgrounds so that children, and others, can protect their skin from the sun’s harmful UV rays. The founder of Shun the Sun is often found at school assemblies educationg kids on the harmful effect that the sun’s rays can have. The foundation is recognized as a Qualifying Charitable Organization under the State of Arizona Tax Laws and Rules. 2. If the organization is a non-profit 501c(3), please describe your relationship with the municipality including past and present support, whether it be through partnerships, collaborations, in-kind contributions, grants, tax-based funding or other. If the organization is a municipality governmental sub-division please enter the text “Not applicable.” This is the first year that Sun the Shun has partnered with Maricopa County for funding. While the Foundation has been active in the community raising funds for shade structures (the Foundation has donated several shade structures), the Foundaiton has recently been very active in pursuing partnerships with government entities and other foundations. The Foundation’s main event is the Gilbert Marathon. For the past several years, Shun the Sun has coordinated the Gilbert Marathon which has attracted almost 900 runners in 2015. In 2016, the Foundation partnered with the Town of Queen Creek where several thousand individuals are expected to participate in the run and other festivities. Our goal is to have several runs throughout the year bringining thousands of runners from throughout the state and southwest. 3. Describe the proposed project and planned goals and activities. The Foundation is a lean organization. The overhead is extremely low. Many of our activities are accomplished by volunteers. Thus, the proceeds that have been collected have had a direct impact in the community through the shade structures that the Foundation procured then donates to the recipients. With the funding, the Foundation can procure at least 5 shade structures. This equals to thousands of people who will benefit from this investment to protect one’s skin. The Foundation will be making a call for applications where school aged children will have to submit an essay on why their school or organization should be the recipient of the shade structures. Our goal is to grow the program into other parts of the Valley, including on tribal land and throughout Arizona in general. Concurrently, Gila River Indian Community Grant Application Grant Cycle 2016 as mentioned before, the Foundation spends much time leading its primary funding event, the Gilbert Maraton, to success and growth. 4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. The Foundation is a lean organization. The overhead is extremely low. Many of our activities are accomplished by volunteers. Thus, the proceeds that have been collected have had a direct impact in the community through the shade structures that the Foudation procures then donates to the recipients. Our request for funding is modest. With the funding, the Foundation can procure at least 5 shade structures. The Foundation will be making a call for applications where school aged children will have to submit entries on why their school, organization should receive the shade structures. Our goal is to grow the program into other parts of the Valley and Arizona. Concurrently, as mentioned before, the Foundation spends much time leading its primary funding event, the Gilbert Marathon, to success and growth. 5. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Arizona, with its beautiful year-round weather, is a draw for people across the country to visit and spend much needed dollars for our economy. But the year-round sunlight also means that our children, if not protected by sun screen, can harm their bodies. The Shun the Sun Foundation primary goal is to educate Arizonans about the importance of protecting one’s skin-especially that of our children. The Foundation is targeting this problem by having Dr. Greg Allen speak to schools, and giving presentations to community groups on the importance of protecting our skin from direct sunlight. With this proposal, the Foundation can educate, and protect many school aged children. The shades will provide a “cooling” place for children and adults at our schools, parks and playgrounds 6. Define the project as a new or continuing program. This project would be considered a continuing program. From one individual whose passion for protecting and educating the public about the affects of too much direct sunlight, Shun the Sun has already undertaken an effort to educate many people about skin cancer. The Gilbert Marathon, a well known community event, has generated much interest from local sponsors, media and organizations throughout the state. With this grant, our Foundation will be able to increase its visibility in the Gila River Indian Community Grant Application Grant Cycle 2016 community and would be proud to call the Gila River Indian Community a partner. Dr. Greg Allen who served on a mission abroad understands the importance of all communities being afforded the same services as others. This is why Shun the Sun Foundation will not limit itself to building shade structures to cetain zip codes. Our mission to educate as many people as possible about protecting one’s skin. 7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. The timeline is flexible. The Gilbert Maraton is in November 2016. Ideally, with the large amount of individuals, organizations, media participating, the Foundation would like to announce the winners of the shades at the Gilbert maraton event. Shun the Sun will start taking applications for shade structures in May prior to the school year ending. 8. Identify other organizations, partners or funders participating in the project and their roles. This year some of the companies we are working with are Forever Young Foundation, Videre Creative, Fat Cats Fun, and JB Water. These are some of our top sponsors this year, but we are always working with new companies. Forever Young Foundation is holding a co-sponsored fundraiser with us at Fat Cats. Videre Creative does our social media, and some of our video advertisements. JB Water does all of our water for our races, and helps set up some of our race fundraisers. 9. Would you be able to implement the proposed plan if your organization received partial funding for this project? Yes, depending on the funding cycle, the Foundation would alter its timeline. 10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously funded by the Gila River Indian Community describe efforts made towards the previously described sustainability plan. The Foundation has been very active raising funds for its program year round. As mentioned above, the Gilbert Marathon is a big draw for our Foundation. We are now expanding to other towns and cities for partnership opportunities like education seminars and running events. The Foundation is actively seeking partnerships with corporations. It also is seeking partnerships with high profile community individuals who have had or have skin cancer. 11. Describe your plan to document progress and results. We believe that taking the approach of procuring and giving shade structures to a defined area of the Valley is prudent. As Dr. Greg Allen’s primary medical practice is in the East Valley, the Foundation has Gila River Indian Community Grant Application Grant Cycle 2016 identified this geographic area as the targeted area. As a point of clarification, Dr. Allen is not a dermatologist. Thus his passion for this cause is not for direct economic benefit to his practice. Our progress for a successful program is to expend annually the funds raised for the procurement of shade structures. 12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. If this information is included in a separate attachment, please indicate that here. The Sun the Shun Foundation has not applied to any other tribe for state shared revenues. Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Budget Period: 2016-2020 For each budget item listed here please provide a narrative description on the following Project Budget Detail page. Proposed Budget Expense Amount Amount In Kind Total Budget requested from requested or contributions (list each budget item) GRIC secured from other funders 1. Procurement of Shade $3,000.00 $10,000.00 $5,000.00 $18,000.00 Structures 2016 2. Procurement of Shade $3,000.00 $15,000.00 $5,000.00 $23,000.00 Structures 2017 3. Procurement of Shade $3,000.00 $25,000.00 $5,000.00 $33,000.00 Structures 2018 4. Procurement of Shade $3,000.00 $35,000.00 $5,000.00 $43,000.00 Structures 2019 5. Procurement of Shade $3,000.00 $50,000.00 $5,000.00 $58,000.00 Structures 2020 6. Click here to enter text. $0 $0 $0 $0 7. Click here to enter text. $0 $0 $0 $0 8. Click here to enter text. $0 $0 $0 $0 9. Click here to enter text. $0 $0 $0 $0 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $15,000.00 $135,000.00 $25,000.00 $175,000.00 Gila River Indian Community Grant Application Grant Cycle 2016 Gila River Indian Community Grant Application Grant Cycle 2016 Project Budget Detail Please provide a narrative description for each of the project budget items listed on the previous page. Include the dollar figure and how it was derived. 1. The main cost is for the procurement of shade structures. There are also fees associated with the placement of the shade structures. The maintenance of the shade structures is left to the recipients. There is a significant life-span for these items. Typically, a shade structure can start at $700.00 for a smaller unit. Shade structures can go into the high thousands figure, but the Foundation believes that the more children that can benefit, the better for our community. The Foundation seeks to purchase the structures from American made companies. We also are very good at negotiating the best price possible for our organization. 2. Click here to enter text. 3. Click here to enter text. 4. Click here to enter text. 5. Click here to enter text. 6. Click here to enter text. 7. Click here to enter text. 8. Click here to enter text. 9. Click here to enter text. 10. Click here to enter text. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Gila River Indian Community Grant Application Grant Cycle 2016 Other explanation: On behalf of the Sun the Sun Foundation, thank you very much for your consideration of this grant application.