Extracted text (via pymupdf_layout)
10770 characters
Admin Tribe Selection Last updated: 09/11/2015 This is my Form. Page 1 Please select to which tribe this Organization has applied to: Salt River 1 of 1 Last updated: 09/17/2015 Page 1 General information Organization Girl Scouts-Arizona Cactus-Pine Council Contact First name Jessica Contact Last name Lyon Contact e-mail jlyon@girlscoutsaz.org Contact phone number 480-353-9790 Address Street 119 E Coronado Road City Phoenix State AZ ZIP Code 85040 What is the name of the program or project for which your organization is requesting grant funds? Leadership Center for Girls and Women For what grant amount has the organization requested from the tribe? 50,000.00 1 of 1 4r10 rip c Department of the Treasury .116,L. Internal Revenue Service P.O. Box 2508 In reply refer to: 0248364799 Cincinnati OH 45201 Aug. 23, 2012 LTR 4168C E0 86-0133397 000000 00 00018172 BODC: TE GIRL SCOUT COUNCIL INC-ARIZONA CACTUS-PINE 119 E CORONADO RD PHOENIX AZ 85004-1512 009074 Employer Identification Number: 86-0133397 Person to Contact: Mrs. K Hopton Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Aug. 14, 2012, 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 September 1959. 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 We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. CAMPAIGNIII ORAGIRLS ,014 kAjjv 7741k$,W Campaign Cabinet Chairs Betsey Bayless July 23, 2015 Rita Maguire Cathy McKee Olesen Barbara Ralston 12% Grant Application Margaret Serrano-Foster C/O Angela Salazar-Willeford Office of Congressional and Legislative Affairs Campaign Girl Members Ellie Fessler 10005 East Osborn Road Brittanee Hustad Scottsdale, AZ 85256 Martha Ryan Jordan Williams Dear Ms. Salazar-Willeford, Campaign Director I am pleased to submit our application to the Salt River Pima-Maricopa Indian Community Janita Gordon requesting $50,000 in support of the new Leadership Center for Girls and Women at Camp Sombrero in Phoenix. We greatly appreciate the invitation to re-apply for the 2015-2016 Board of Directors Margaret Serrano-Foster, Choir grant cycle. Lydia Aranda Liz Archuleta We are thrilled to announce that construction commenced in June of 2015 and is expected to Elaine Armfield be completed by September of 2017. To date, we have raised over $9.6 million toward our Denise Blommel $15 million goal. We are confident in our ability to raise the remaining funds needed. This Andrea Borg request is an integral part of the Girl Scouts' Leadership Campaign for Girls and Women in Lupe Camargo Arizona as it will help us leverage additional gifts. Patrick Edwards Yvonne Fortier The Girl Scouts are thrilled to count the Salt River Pima-Maricopa Indian Community as a Tomas Guerra Deb Gullett partner, and truly look forward to enriching our relationship and moving forward together. Raquel Gutierrez To that end, please contact Jessica Lyon, Portfolio Manager—Advancement & Campaigns, at Brian Hemmerle 602/452-7088 or jlvon@girlscoutsaz.org with any questions. Jennifer Hinkel Michael G. Hoffman Again, thank you for this opportunity. Your support and community leadership is a lasting Allison House, DM D investment in Arizona's young women. Teri Twarkins Kelley Gordon Lewis With deepest gratitude, Rita Maguire Jannis Mossman Maria-Elena Ochoa Cathy McKee Clasen Bessie Payan / Tamara Wood ury Janey Pearl / CEO Harriet Redwine Karilyn Van Oosten cc: Gary Bohnee Cheryl Walsh Tanya Wheeless Larry Wulkan Ed Zito girl scouts arizona cactus-pine 119 E Coronado Road, Phoenix, AZ 85004 602.452.7030 I 800.352,6133 campaign@girlscoutsaz.org SALT RIVER PIMA-MARICOPA INDIAN COMMUNITY 10,005 E. Osborn Road, Scottsdale, Arizona 85256 / Phone 480-362-7520 / Fax 480-362-7593 12% Gaming Contributions Application Date of Application: July 23, 2015 Organization Name: Girl Scouts—Arizona Cactus-Pine Council Organization/Municipal Government Street & Mailing Address: I 19 E. Coronado Road, Phoenix, AZ 85004 Contact Person and Project Manager if different from Contact Person: Jessica Lyon Title: Portfolio Manager — Advancement & Campaign Address: 119 E. Coronado Road, Phoenix, AZ 85004 Phone: 602/452-7088 Fax: 602/452-7100 Email Address: ilvongirlscoutsaz.org Project Name: Leadership Center for Girls and Women Please provide a brief description of the project submitted to the 12% SRPMIC Grant program. The Leadership Center for Girls and Women will be a landmark facility on the beautifully situated 14.5- acre site of the Girl Scouts' Camp Sombrero in South Phoenix. Camp Sombrero is situated at the foot of South Mountain and has not been renovated since the 1960s. With 25,000 girl members (k-12) and growing, we have long since outgrown the current, antiquated buildings that only accommodate a mere 100 girls. This significantly inhibits use of this valuable resource. With 85% of our girl membership residing in Maricopa County, having close access to an overnight camping experience will remove barriers to participation (i.e., financial, transportation, distance from home, etc.), drastically altering the Girl Scouting experience in Arizona and increase the overall capacity of our Council to serve more girls. The Leadership Center for Girls and Women will have the capacity for 300 girls or adult volunteers, and will provide opportunities for girls across Arizona to gather for programs. The renovations are designed to honor the environment/construct a permanent facility providing the safe space Arizona's girls need to build their leadership, character and skills. The construction of the Leadership Center for Girls and Women is part of the Campaign for Girls in Arizona, a $15 million capital campaign aimed at reaching more girls in underserved areas, developing and supporting more adult volunteers, and increasing innovative programming in the areas of healthy living, STEM, financial literacy, global citizenship, and environmental leadership. Specifically, this request is to fund the general costs associated with the Campaign for Girls in Arizona, including, but not limited to, the renovation of Camp Sombrero and the construction of the Leadership Center for Girls and Women. Construction commenced in June with expected completion within 24 months. Beginning Date of Project: End Date of Project: June 15,2015 September 30, 2017 Geographic Area to be served: State of Arizona (facility in South Phoenix) ** Attach Detailed Budget** Amount of Total Project: Amount of 12% Request: (No Multi-Year Request will be accepted) $15,000,000 $50,000 If the Amount of funding received is less than the amount needed for the project, do you have other funds to complete the project? (Please Explain): Yes. The Campaign for Girls is a $15 million dollar campaign. To date, we have raised $9.6 million dollars in funding, which includes $7.1 million raised from the philanthropic community and $2.5 million allocated from Council reserves. We have an additional $11.75 million in pending requests. Furthermore, the Virginia G. Piper Charitable Trust has invited GSACPC to submit a request for $1.5 million once we have reached 75% of our fundraising goal. The GSACPC Board of Directors is also intimately involved with the Campaign for Girls in Arizona, with many board members serving as Campaign advisors, and all board members serving as both donors and prospect liaisons. If you receive SRPMIC 12 % funding, will it be spent (Check One): LI Monthly n Quarterly X Lump Sum List of SRPMIC 12% funds you have received in the past. -Campaign for Girls, November 2013, $20,000 -Campaign for Girls, August 2014, $20,000 -Social Just Us (Baby Camp, Girl Scouts Beyond Bars, etc.,) December 2012, $20,000 List any other of other 12 °Ai funds your organization may be seeking from other Tribal Governments in 2015-2016. -Campaign for Girls, Fort McDowell Yavapai Indian Community, $10,000 (pending) -Campaign for Girls, Tohono O'odham Nation, $500,000 (pending) List any other funds you have received from the SRPMIC (Enterprises Included) and identify the source: n/a Funding for project/programs may be based on available funding. As such, if funding were not available for the full the amount of request how would you prioritize funding. A.) $50,000 to fund the construction of the Leadership Center for Girls and Women B.) $40,000 to fund the construction of the Leadership Center for Girls and Women C.) $20,000 to fund the construction of the Leadership Center for Girls and Women D.) $15,000 to fund the construction of the Leadership Center for Girls and Women Which municipal governmental entity will serve as your pass through or accept 12% funds on your behalf? Maricopa County Attn: Amanda Nash 301 W. Jefferson St., 10th Floor Phoenix, AZ, 85003 (602) 506-4485 nasha001@mail.maricopa.gov By execution of the 12% Gaming Contribution Grant Application the undersigned agrees that the information contained in the Application is true to the best of the Applicants knowledge. The Applicant shall notify the SRPMIC if any information in this Application changes. July 23,2015 Signatureefrir the Applioafii Date Tamara Woodbury, Chief Executive Officer Name and Title The Application shall be signed by the senior elected official of the local government, or in the case of a non-profit entity, the Chief Executive Officer authorizes to commit the non-profit entity to apply for, accept, and implement an award from the SRPMIC utilizing 12% Gaming Contributions. Budget Leadership Center for Girls and Women Capital Project Budget Element Amount Leadership Center $5,115,000 Volunteer Building $710,000 Maint. Building $25,000 Pool building $600,000 Activity Buildings $625,000 Cabin Units B, C, D, E $3,700,000 Cabin Units A $775,000 Site $3,400,000 Offsite $300,000 Total $15,250,000