2015 APPLICATIONS 4.PDF

Maricopa County — Formal (2015-04-22)

Extracted text (via pymupdf_layout) 47855 characters

Created Friday, December 05, 2014
Updated Monday, March 02, 2015
Page 1
General information
General information | Organization SEQUOIA SUPPORT SERVICES, EDKEY INC.
General information | Contact First name BONNY
General information | Contact Last name BEACH
General information | Contact e-mail bonnybeach@aol.com
General information | Contact phone number 602 448 0935
Address
Address | Street 1648 SO 16TH St
Address | City Phoenix
Address | State Arizona
Address | ZIP Code 8 503 4
From what tribe is the organization requesting the grant?
Fort McDowell Yavapai Nation
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, enter the amount to be requested each year.
Amount
Year 1 $
Year 2 $
Year 3 $
Year 4 $
Year 5 $
Page 1

INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY.
P. 0. BOX 2508
CINCINNATI, OH 45201
Employer Identification Number:
DateMAR 0 6 2003 74-3033931
DLN:
17053267000012
CHOICE EDUCATION AND DEVELOPMENT Contact Person: ID4 31380
CORPORATION ELIZABETH WAGNER
C/O RONALD W BONANNI Contact Telephone Number:
933 W CULVER ST (877) 829-5500
PHOENIX, AZ 85007 Accounting Period Ending:
June 30
Form 990 Required:
Yes
Addendum Applies:
Yes
Dear Applicant:
Based on information supplied, and assuming your operations will be as
stated in your application for recognition of exemption, we have determined
you are exempt from federal income tax under section 501(a) of the internal
Revenue Code as an organization described in section 501(c) (3).
We have further determined that you are not a private foundation with
the meaning of section 509(a) of the Code, because you are ar organization
described in sections 509(a)(1) and 170(b)(1)W(ii).
If your sources of support, or your purposes, character, or method of
operation change, please let us know so we can consider the effect of the
change on your exempt status and foundation status. In the case of an amend
ment to your organizational document or bylaws, please send us a copy of the
amended document or bylaws. Also, you should inform us of all changes in your
name or address.
As of January 1, 1984, you are liable for taxes under the Federal
Insurance Contributions Act (social security taxes) on remuneration of $LCO
or more you pay to each of your employees during a calendar year Yoxi ar
not liable for the tax imposed under the Federal Unemployment Tax Act r7UTA;
Since you are not a private foundation, you are not subject to the excise
taxes under Chapter 42 of the Code. However, if you are involved in an exces
benefit transaction, that transaction might be subject to the excise taxes
section 4958. Additionally, you are not automatically exempt from other
federal excise taxes. If you have any questions about excise, employment, Jr
other federal taxes, please contact your key district office.
Grantors and contributors may rely on this determination unless the
Internal Revenue Service publishes notice to the contrary. However, if
lose your section 509(a)(1) status, a grantor or contributor may not ::•e1y
on this determination if he or she was in part responsible for, or was 9wae
Letter 94'7 ,D016:

-2-
CHOICE EDUCATION AND DEVELOPMENT
of, the act or failure to act, or the substantial or material change on the
part of the organization that resulted in your loss of such status, or if he or
she acquired knowledge that the Internal Revenue Service had given notice that
you would no longer be classified as a section 509(a)(1) organization.
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 Code sections 2055, 2106, and 2522.
Contribution deductions are allowable to donors only to the extent that
their contributions are gifts, with no consideration received. Ticket pur-
chases and similar payments in conjunction with fundraising events may not
necessarily qualify as deductible contributions, depending on the circum-
stances. See Revenue Ruling 67-246, published in Cumulative Bulletin 1967 2
on page 104, which sets forth guidelines regarding the deductibility, as chari
table contributions, of payments made by taxpayers for admission to or other
participation in fundraising activities for charity.
In the heading of this letter we have indicated whether you must file Form
990, Return of Organization Exempt From Income Tax. If Yes is indicated, You
are required to file Form 990 only if your gross receipts each year are
normally more than $25,000. However, if you receive a Form 990 package in the
mail, please file the return even if you do not exceed the gross receipts test
If you are not required to file, simply attach the label provided, check the
box in the heading to indicate that your annual gross receipts are normally
$25,000 or less, and sign the return.
If a return is required, it must be filed by the 15th day of the fiE.:?-1
month after the end of your annual accounting period. A penalty of $20 a day
is charged when a return is filed late, unless there is reasonable cause for
the delay. However, the maximum penalty charged cannot exceed $10,000 or
5 percent of your gross receipts for the year, whichever is less. For
organizations with gross receipts exceeding $1,000,000 in any year, the penalty
is $100 per day per return, unless there is reasonable cause for the delay.
The maximum penalty for an organization with gross receipts exceeding
$1,000,000 shall not exceed $50,000. This penalty may also be charged if a
return is not complete, so be sure your return is complete before you file it
You are required to make your annual information return, Form 990 or
Form 990-EZ, available for public inspection for three years after the later
of the due date of the return or the date the return is filed. You are also
required to make available for public inspection your exemption applicaticm
any supporting documents, and your exemption letter. Copies of these
documents are also required to be provided to any individual upon written 31
person request without charge other than reasonable fees for copying and
postage. You may fulfill this requirement by placing these documents on
Internet. Penalties may be imposed for failure to comply with these
requirements. Additional information is available in Publication 557,
Tax-Exempt Status for Your Organization, or you may call or toll free
number shown above.
Letter 947 120/CG

-3-
CHOICE EDUCATION AND DEVELOPMENT
You are not required to file federal income tax returns unless you are
subject to the tax on unrelated business income under section 511 of the Code.
If you are subject to this tax, you must file an income tax return on Form
990-T, Exempt Organization Business Income Tax Return. In this letter we are
not determining whether any of your present or proposed activities are unre-
lated trade or business as defined in section 513 of the Code.
You need an employer identification number even if you have no employees.
If an employer identification number was not entered on your application, a
number will be assigned to you and you will be advised of it. Please use that
number on all returns you file and in all correspondence with the internai
Revenue Service.
If we have indicated in the heading of this letter that an addendum
applies, the enclosed addendum is an integral part of this letter.
Because this letter could help resolve any questions about your exernp:
status and foundation status, you should keep it in your permanent records.
If you have any questions, please contact the person whose name and
telephone number are shown in the heading of this letter.
Sincerely yours,
ctez.,
Lois G. Lerner
Director, Exempt Organizations
Letter 94'

ARTICLES OF MERGER JUN 1 1 2.012
MERGING EDKEY, INC. WITH AND INTO
CHOICE EDUCATION AND DEVELOMENT CORPORATION AS
Edkey, Inc., an Arizona nonprofit corporation and Choice Education and Development
Corporation, an Arizona nonprofit corporation, hereby adopt the following Articles of Merger to
merge Edkey, Inc. with and into Choice Education and Development Corporation, with UM e
Laucation iind I )evelopment Corporation being the corporation survivittiikftWithe "Merger"):
FIRST: The Plan of Merger is being simultaneously filed with the Arizona Corporation
Commission.
SECOND: The names of the corporations that are the parties to this merger are Edkey, Inc., an
Arizon nonprofit corporation, and Choice Education and Development Corporation, an Arizona
nonprofit corporation (the "Surviving Corporation").
THIRD: The known place of business of the Surviving Corporation, is 1460 S. Home, Ste, 632,
Mesa, AZ 85204.
FOURTH: The name and address of the statutory agent of the Surviving Corporation is Patric R.
Greer, 1460 S. Home, Mesa, AZ 85204-5760.
FIFTH: The Articles of Incorporation of the Surviving Corporation, shall remain in full force and
effect, except, however, Article I of such Articles of Incorporation is hereby amended in its entirety
to read as follows:
'Article 1: Name. latit,)e namo, of the .Corpora•ion is Etlkey, inc."4
SIXTH: The Board of Directors of each party to the Merger approved the Merger, and the Plan of
Merger at meetings duly called and properly held on R , 2012.
SEVENTH: Both parties to the Merger are Arizona nonprofit corporations with no members.
Accordingly, no vote of shareholders or members is required,
EIGHTH: The Merger shall be effective as of 11:59 p.m. on June 30, 2012.
IN WITNESS WHEREOF, the undersigned have hereunto set their hands this 7 day of
-73-I-4. %A- .da .2012,
EDKEY, INC. CHOICE EDUCATION AND
) DINH aPORATioN
By: ' „ By:,
Niiir T. 2 Name: k.
Title: -5.1/42. —rt,Fyvi _ • (.1 . -"I \ I
DI-504/S3W9 MO5/5629807 NitY30

“PUTTING CHILDREN FIRST”
SEQUOIA SUPPORT SERVICES, EDKEY
GAMING COMMISSION PROPOSAL 2015
Fort McDowell Yavapai Nation
March 2, 2015
Hello,
Thank you for considering this proposal.
Sequoia Support Services (SSS) is part of EDKEY Inc. a 501c3 nonprofit which provides both educational
services and behavioral health services to youth through its charter school system. SSS is an AZ licensed
behavioral health outpatient treatment agency. Its’ mission is to promote healthy, safe and successful
young people. SSS provides high quality, integrated behavioral health services, which includes
counseling and educational services. The target population includes high needs, culturally diverse
youth, ages 5-18. Many of these youth are intertribal young people living in urban areas.
The Goals & Activities of Putting Children First Project include:
Goals- To provide integrated counseling services to homeless and high needs young people not covered
by AHCCCS or other health care plans. This proposal is targeting the two Children First Academy sites,
one in Phoenix and one in Tempe.
1. Objective: Provide group counseling, one hour weekly for up to 100 youth (specific to addressing
mood management, improving behavior, and increasing academic engagement/achievement).
2. Objective: Provide individual counseling, 30 minutes to an hour for up to 20-30 youth weekly, for
12 week periods. (Four sessions annually = 80-120 youth served annually)
3. Objective: Provide Parenting Group Support up to 2x monthly for 2 hour session seminars. (specific
to Positive Discipline, Strengthening Families, Finance/Budgeting, Substance Abuse Prevention)
Putting Children First satisfies two of the funding priority areas of Fort McDowell Yavapai Nation:
education and health care. Counseling addresses both behavioral health needs of youth and the
academic readiness needs necessary for educational engagement and advancement.
The needs, problems and target population to be addressed by “Putting Children First” are
multi-ethnic, extremely high risk young people attending the Children First Academies in Phoenix and
Tempe. Over 75%, of these young people are classified as “homeless” and are in need a
comprehensive counseling and family support services. These sites serve K-12 grade youth.
This proposal would fund one full-time licensed counselor and the case management support to
provide counseling services to these two sites. This proposal would support the many children who are
not currently enrolled in AHCCCS. (AZ health insurance for low/no income families) Often families
struggle with enrollment in the system, maintaining eligibility, particularly the logistics and legal address
requirements. Their children often are left out of services because there is little to no funding for
counseling youth who are not currently enrolled, or who do not qualify for AHCCCS.
This application proposes to fund services to those highest need children. On the scale of “Adverse
Childhood events” (which is an evidence based predictor of health and well-being). Over half of the
SEQUOIA SUPPORT SERVICES, EDKEY INC.
1648 So 16th St, Phoenix AZ 85034
602-448-0935- Bonny Beach, Program Director
1

“PUTTING CHILDREN FIRST”
SEQUOIA SUPPORT SERVICES, EDKEY
GAMING COMMISSION PROPOSAL 2015
Fort McDowell Yavapai Nation
children screened cited multiple adverse events in the last year. Risk is 2/10 in last 5 years. These
children scored 6/10 in the last 12 month period. These children are dealing with trauma,
homelessness, family violence, substance abuse and addictions as well as cultural discrimination and
lack of academic supports necessary for successful engagement and achievement. Other issues
identified included depressive and anxiety disorders, as well as Post Traumatic Stress and conduct
disorders
The Putting Children First is a new project. The time line proposed is for 1 year. The project will begin
in the first funded month, preferably August 2015. It will continue for 12 months. If Ft McDowell
Yavapai nation is willing to fund for additional years, it would be greatly appreciated and helpful.
EDKEY and Sequoia Support Services are committed to this project. Other partners working closely to
manifest the full-service community school model include Phoenix Children’s Hospital, Children First
Academy Phoenix & Tempe.
Sustainability is a continual concern addressed by SSS. The Project Director would continue to write
and submit grant proposals, organize fundraising and get young people qualified as quickly as possible
for AHCCCS.
Documentation will be organized through daily progress notes on young people’s sessions, weekly
services logs, monthly program report to the Program Director and quarterly summary progress reports
to the legal entities requiring reports.
Currently, this is our application for tribal support. We so appreciate your generosity and willingness
to help our community!
Sincerely,
Bonny Beach, MA MS LISAC
Project Director
Sequoia Support Services, EDKEY Inc.
602-448-0935; bbeach@edkey.org
www.sequoiasupportservices.org
1648 So 16th St, Phoenix AZ 85034
SEQUOIA SUPPORT SERVICES, EDKEY INC.
1648 So 16th St, Phoenix AZ 85034
602-448-0935- Bonny Beach, Program Director
2

EDKEY INC.
SEQUOIA SUPPORT SERVICES
AIM HIGH! Sequoia Support Services OTC6662 is an Arizona Licensed behavioral health agency.
MISSION
Sequoia Support Services mission is to support the development of safe, successful, healthy and drug-free youth and
families.
TARGET POPULATION
Youth ages 6-18, specializing in services for youth, children and adolescents experiencing the effects of adverse
childhood events, grief and trauma, toxic stress, (poverty, violence, abuse, substance abuse) and mental health
disorders like depression, anxiety etc.
WHAT IS COUNSELING?
Counseling and support services are CONFIDENTIAL. These services provide a highly skilled caring adult to sit and
listen with the young person and provide supports to improve mood management, behavior and academic
achievement. Areas most often addressed include processing losses, improving self-esteem, mood and behavior
management, conflict resolution, relationship and life skills.
GOALS
1. Promote Health & Safety
2. Develop Capable, Caring, Contributing Youth
3. Support Family & Community Connections
4. Promote Life-Long Learning
Support Services
School and Clinic Based Outpatient Counseling Services
Offer counseling supports to identified youth and families within the scheduled school sites. Counselors provide
assessment, brief intervention, conflict resolution and life skills support groups specific to site/classroom/youth needs.
Families are invited to participate in support activities, child and family team meetings, parent education and family
support groups. SSS will help to provide emergency intervention teams to sites when deaths or crisis occurs.
Circle of Health Recovery School (COHRS) and Intensive Outpatient Counseling Services
In partnership with Sequoia Charter School District, COHRS is a “school within a school”. COHRS is a unique day
treatment/recovery program for 6-12 grades that includes special education supports. COHRS offers an integrated
mental health, substance abuse treatment/prevention, and educational model. Youth enrolled receive up to 7 hours of
direct counseling services per week, as well as other supports. Enrollment is continuous and open.
Home Based Outpatient Counseling Services
Offer some home based counseling services within Maricopa county neighborhoods, mental health, substance abuse
treatment and family supports. Counseling services are provided to youth and families within their home or group
home settings that specifically address their behavioral health needs.
Circle of Health Prevention Program and Intervention Services
School based youth development and family strengthening activities that include Classroom Presentations related to
 Life skills development  Drama activities & culturally relevant arts and
 Leadership skill development crafts
 Research based substance abuse and violence  Cultural restoration and affirmation
prevention education curriculum
1648 So. 16th St, CFA, Family Services Clinic; Phoenix, Arizona 85034
Phone: 602-448-0935; Bonny Beach, Program Director
Main Phone- 602-422-9951; www.sequoiasupportservices.org

EDKEY INC.
SEQUOIA SUPPORT SERVICES
Community based presentations that include
 Mentoring  Parenting support talking circles and mini-
 After school or “Critical Hours” supervision & seminars
activities  Family Strengthening Weekend Activities
Staff & Community Training, Technical Assistance & Educational Services:
We offer a wide variety of technical assistance and training opportunities.
Some of the trainings include:
 Youth Mental Health First Aid Training  Culturally Respectful program planning and service
Certification delivery
 Improving Classroom and School Climate  Youth and Family Services Program Design and
 Setting up Positive Discipline within the classroom Development
 Understanding Trauma and its impact on  Grant Writing and Resource Development
learning/functioning  Substance Abuse Counselor Certification and
 Brain-Based Teaching & Learning Substance Abuse Prevention Specialist Training
 Teaching Kids to CARE  Youth to Youth Conferences and Celebrating
 Developing Capable People Indian Families Mini-Conference Series
 Building Assets & Protective Factors  Plus many others
 Community School Mobilization
WHO WE ARE
EDKEY Inc. was founded in 1996. EDKEY Inc. is a 501(c)3 non-profit organization. EDKEY operates 18 school sites
through out Arizona as well as a distance-learning program. Sequoia Charter Schools was founded with the intent of
working together WITH families in the education of their children in an environment where every child is know by all of
the staff in a very positive environment with high expectations. The working relationship of the family and the school is
critical to the success of the student.
In 2013 EDKEY Inc. invited the American Indian Prevention Coalition to join their organization and together they
organized a system wide behavioral health agency, Sequoia Support Services. SSS is an AZ licensed behavioral health
agency that provides culturally respectful, quality counseling and behavioral health services to youth and families
within the EDKEY system of care. Sequoia Support Services’ staff has been working with high needs youth and families
for ten+ years. This staff is competent in working with conduct and mental health issues, trauma and loss, substance
abuse and addictions as well as developing essential life skills and improving school engagement and performance
STAFF:
 SSS Program Director- Bonny Beach, MA MS LISAC 602-448-0935
 AWARE YMHFA Project Coordinator- Bonny Beach
 SSS Clinical Director- Emilie Karlin, Ph.D. 602-422-9951
 SSS Counselors- Melissa Alamprese, MS; Crystal Novak, MS, Jessica Hunter, MS; (Masters Level Interns also
provide counseling)
 COHRS Lab Instructors- Fayette Lee, Treia Lee
 SSS Intervention/Prevention Specialists- Danielle Hagerty, Kerry Iyua
 SSS Prevention Specialist, Traditional Practitioner- Boyd Tsosie
 Billing and ADMIN assistant- Crystal Yazzie, MS
Partners:
Regional Behavioral Health Authorities- Gila River RBHA and Mercy Maricopa RBHA.
1648 So. 16th St, CFA, Family Services Clinic; Phoenix, Arizona 85034
Phone: 602-448-0935; Bonny Beach, Program Director
Main Phone- 602-422-9951; www.sequoiasupportservices.org

Created Friday, February 06, 2015
Page 1
General information
General information | Organization Back To School Clothing Drive
General information | Contact First name Nikki
General information | Contact Last name Fisher
General information | Contact e-mail nikki@btscd.com
General information | Contact phone number 602-256-9408
Address
Address | Street 360 E Coronado Rd #200
Address | City Phoenix
Address | State AZ
Address | ZIP Code 8 5 004
From what tribe is the organization requesting the grant?
Fort McDowell Yavapai Nation
Total grant amount request
$25,000
The Gila River Indian Community offers multi-year awards. If your organization is requesting a
multi-year grant for this project or program, enter the amount to be requested each year.
Amount
Year 1 $
Year 2 $
Year 3 $
Year 4 $
Year 5 $
Page 1

Crt IRS Internal Department Revenue of the Treasury Service
P.O. Box 2508 In reply refer to: 0248219411
Cincinnati OH 45201 Jan. 30, 2015 LTR 4168C 0
74-2382265 000000 00
00020132
BODC: TE
BACK-TO-SCHOOL CLOTHING DRIVE
ASSOCIATION
360 E CORONADO ROAD
PHOENIX AZ 85004
014117
Employer Identification Number: 74-2382265
Person to Contact: Laura A. Botkin
Toll Free Telephone Number: 1-877-829-5500
Dear Taxpayer:
This is in response to your Jan. 21, 2015, 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 January 1986.
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.

0248219411
Jan. 30, 2015 LTR 4168C 0
74-2382265 000000 00
00020133
BACK-TO-SCHOOL CLOTHING DRIVE
ASSOCIATION
360 E CORONADO ROAD
PHOENIX AZ 85004
If you have any questions, please call us at the telephone number
shown in the heading of this letter.
Sincerely yours,
bat. P 4,4044-e't
Doris Kenwright, Operation Mgr.
Accounts Management Operations 1

2015 Fort McDowell Yavapai Nation Grant Application
Submitted by Back To School Clothing Drive
Fort McDowell Yavapai Nation Grant Application Narrative
1) Describe the proposed program or project- project is continuing.
The Stardust Foundation began the Student Attire For Education (SAFE) program to help Title I
elementary schools provide clothing assistance to children in need. In 2000, BTSCD became an
operational partner with the Stardust Foundation for SAFE because of our experience and
established relationships with Maricopa County Title I schools. SAFE offers approved schools
matching-grants of up to $2,500 that, when combined with the school’s money, provides as
much as $5,000 to spend. These funds must purchase school uniforms, clothing, and supplies
through the BTSCD SAFE online retail store.
In 2011, we realized if we created our own retail store and provided a matching grant to schools,
we could build a social enterprise to generate new revenues for our organization. Those revenues
help us serve even more kids and build our operating reserves. When a school receives our
matching grant, instead of buying uniforms through commercial retail, they purchase them
through our online retail store, giving them a two for one deal they cannot get anywhere else. We
invest the net profits from those sales back into the program to serve more children in more
schools and build long-term sustainability for our organization. And it’s working. Today, we
have over 260 schools in the program, up from 30 when we started the store just three years ago.
Here’s how it works – say a school has $2,500 to spend on uniforms. With our exclusive
matching grant, their money is doubled to $5,000, if and only if, they shop in our online store.
Because we can completely outfit a child for about $30, including sneakers, each time a school
shops with us, 83 more kids automatically get uniforms – 83! We believe that is a game changer.
Throughout the year, schools apply for a grant on our website and receive a response within one
week. Approved schools receive a code to order school uniforms, clothing, and supplies online.
Merchandise is sent directly to the schools at no charge either via direct from the vendor or by
Epi-Hab. Epi-Hab is a nonprofit providing meaningful employment for individuals with epilepsy
and other challenges. Direct shipments arrive within four days and Epi-Hab orders arrive in one
to two days. BTSCD confirms delivery and reconciles orders and payment with the school within
two weeks after delivery. More than 93 percent of participating schools are satisfied with SAFE,
and 89 percent would apply again and recommend SAFE to other schools.
No other Arizona organization offers a matching-grant and online retail store for school
uniforms. Each year, BTSCD works in close collaboration with the Virginia G. Piper Charitable
Trust to offer matching grants to the schools they provide funding to purchase school uniforms,
which annually totals approximately $500,000 to 290 schools. Those schools are invited to apply
for up to $2,500 in matching-funds if the schools use their Piper Trust funds to shop through the
BTSCD SAFE online store. To date over 226 schools take advantage of this opportunity,
leveraging the Piper Trust grant to double the impact into the community. BTSCD is currently
focusing its marketing efforts to capture the 64 schools that currently do not utilize SAFE.
Short-term objective:
#1: Retain current 260 schools in the program and attract 10 new schools each year.
Page 1 of 3

2015 Fort McDowell Yavapai Nation Grant Application
Submitted by Back To School Clothing Drive
Long-term Objectives:
#1: Increase net proceeds by 16-28% annually.
#2: Maintain minimum 90% satisfaction rate from partner schools.
#3: Replace annual $50,000 investments from both the Stardust Foundation and BHHS Legacy
Foundation with net proceeds from retail sales and other investors.
#4: Expand program to offer grants to Title I schools in other Arizona counties.
This success relies on a continued partnership with the Piper Trust. Other activities to achieve
plans include improving the supply chain operation and targeting less than seven days fulfillment
time for orders. Long-term expectations include further developing the collaboration with the
Piper Trust to help them administer their Back to School grants program, and to generate enough
revenue to replace the $50,000 from both the BHHS Legacy and Stardust Foundations. Based on
current projections, we expect to attain that goal by year 2015. We measure changes and make
improvements through semi-annual surveys of participating schools.
2) Describe how the proposed program or project satisfies one or more of Fort McDowell’s
funding priorities.
This request satifies the education focus by helping families properly clothe and supply their
children for school, and helping schools on reduced budgets stock their clothing and supply
closets for their neediest students. The goal of SAFE is to help Title I Maricopa County
elementary schools reduce a barrier to attendance by providing clothing assistance to children in
need.
3) Identify the need your grant will address, target population and number of people
served.
It isn’t unusual to hear children complain they don’t have a thing to wear, but in thousands of
Arizona homes this isn’t an exaggeration. Some children actually stay home because their
families can’t afford the required attire – perhaps they can only afford one uniform set, so only
one sibling goes to school each day. To give these working poor families the help they need,
some schools maintain limited onsite clothing closets.
BTSCD offers services to Title I schools. Title I designation means that at least 40% of students
qualify for the National School Lunch Program, or NSLP. Each year, families complete an
application to qualify for the NSLP when they enroll their children in school. The eligibility
range for NSLP free or reduced-price lunches is an annual income around $40,000 for a family
of four. When families do not have money for food, they do not have money for clothes. State
budgets cuts reduce the amount of money schools have to help these students. When students
attend school without the right clothing, their self-esteem plummets and their education suffers.
Schools must complete an application for approval to qualify for SAFE. The school’s parent
coordinator, social worker, or nurse select students for participation. The criteria for selection is
that the student must participate in the NSLP. SAFE serves an estimated 15,000 students from
low-income families annually.
4) Brief description of partners in the program or project or other entities providing
funding and support. Indication of any other applications made to and/or awards
Page 2 of 3

2015 Fort McDowell Yavapai Nation Grant Application
Submitted by Back To School Clothing Drive
granted by other tribes/nations.
BHHS Legacy Foundation commits almost $50,000 annually to support SAFE. We also have a
$25,000 a year for five years from Gila River Indian Community from 2014-2019.
In 2009, BTSCD began collaborating with the Piper Trust. The Piper Trust awards $500,000
each spring to 290 schools to purchase schools clothes for their needy students. BTSCD informs
recipients about our programs, including the opportunity to double their award up to $2,500
through SAFE.
5) Provide a timetable for implementation.
Schools can apply for grants and shop the online retail store at any time during the school year.
The Piper Trust awards their school grants and BTSCD presents the SAFE program and online
retail store information to the Piper Trust recipients in the spring.
Page 3 of 3

Back To School Clothing Drive
2015 Operating Budget
New Clothes, New
Beginnings and
Source General Stitches of Love SAFE Totals
Revenus
Foundations & Corporations 60,000 360,000 111,400 531,400
School Purchases 260,000 260,000
City Government 61,000 61,000
Special Events 50,000 50,000
Individuals 17,533 20,834 61,233 99,600
Total Revenues 127,533 441,834 432,633 1,002,000
Expenses
Salaries 44,800 72,625 72,625 190,050
Employee Benefits & Taxes 10,200 14,875 14,875 39,950
Employee Education & Training 5,000 5,000
Professional Fees & Contracts 28,000 28,000
Communication- Phone & Internet 250 250 500
Utilities 2,250 2,250 4,500
Rent, Bldg, & Grounds 17,333 17,334 17,333 52,000
Non-payroll Insurance 5,000 5,000
Postage 2,000 2,000
Membership Dues & Subscriptions -
Advertising, Publications & Printing 4,000 2,000 6,000
Office Supplies 200 500 300 1,000
Equipment Rental & Maintenance 1,500 500 2,000
Specific Assistance to Individuals 311,000 305,000 616,000
Fundraising 15,000 15,000
Technology 2,500 2,500 5,000
Operating 15,000 15,000 30,000
Total Expenses 127,533 441,834 432,633 1,002,000

Created: 03/30/2015
Last updated: 04/07/2015
Page 1
General information
Organization Fire District of Sun City West
Contact First name Tim
Contact Last name Van Scoter
Contact e-mail tvanscoter@scwfire.org
Contact phone number 6028812733
Address
Street 18818 N. Spanish Garden Drive
City Sun City West
State AZ
ZIP Code 85375
From what tribe is the organization requesting the grant?
Fort McDowell Yavapai Nation
Total grant amount request
10,260
The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this
project or program, enter the amount to be requested each year.
Amount
Year 1
Year 2
Year 3
Year 4
Year 5
1 of 1

1-41 Department of the Treasury In reply refer to: 0441222356
a° Internal Revenue Service Oct 11, 2012 LTR 147C
Ogden, UT 84201 86-0503076
FIRE DISTRICT OF SUN CITY WEST
SUN 18818 CITY N SPANISH WEST GDN DR l&A Tracking #: A10292012264665
AZ 85375-4455 185 NP I #: 1215935119
Taxpayer Identification Number: 86-0503076
Form(s):
Dear Taxpayer:
This letter is in response to your telephone inquiry of October 11th, 2012.
Your Employer Identification Number (EIN) is 86-0503076. Please keep this number in
your permanent records. You should enter your name and your EIN, exactly as shown
above, on all business federal tax forms that require its use, and on any related
correspondenc e documents.
If you have any questions regarding this letter, please call our Customer Service
prefer, Department you may at 1-800-829-0115 write to us at the between the hours of 7:00 AM and 10:00 PM. If you
When you write, please include a telephone address shown at the top of the first page of this letter.
best time to call. number where you may be reached and the
Sincerely,
ppluve
K. Bravo
0441122356
Customer Service Representative
TOTAL P.02

TountH at Marto a
*tat of Arizona
@Mu of Op (tlerk
'tat e of Arizona
SS.
Mounig r;1: ariropa
,f Ltez Poobail, Wed 114 goal,c1 gi;i4e9m6oxt do
Aewedy red* Rtat the following is a true and correct xtract from the
minutes of the Board of Supervisors' meeting held May 1981:
ORGANIZATION OF FIRE DISTRICT IN SUN CITY WEST
(Attached)
• I
3n Illituros 31111preof, /gate& Aeseemsoita 4e0
,my 4a,„.4 and 5 0 Yea.Wav gottoed
goote.al aerweestir .9:at
da, 12th day.,309 M y, 1981
County Recorder
County Elections
County Treasurer
County Assessor
CourwtyController
County Engineer 21601.4e,
Mountain Bell Telephone
Arizona Departm t of Revenue lioarb of thiprotooro
Victor Simpson
File

ORGANIZATION OF FIRE DISTRICT IN SUN CITY WEST, PHASE I
Motion was made by Mr. Koory- and unanimously carrie that the following
resolution be adopted:
RESOLUTION DECLARING FIRE DISTRICT IN SUN CITY WEST PHASE I ORGANIZED
WHEREAS, an election was duly held on April 27, 1981, a: provided by law for
the organization of Fire District in Sun City West , Phase I, to 1 e administered by a
District Board and Chief, at which election 1041 qualified voters voted "Yes" and 707
voted "No"; and
WHEREAS, the following votes were cast for Board of Dire ors of Fire District
of Sun City West Phase I:
Board of Directors Votes Cast
Barraco, Tony 844
Faaborg, Jens A. 574
Geyer, Charles A. 993
Gilchrist, David E. 630
Hinske, Edward R. 575
Lowe, Dolores 919
Maley, James 894
Perril, Lester S. 580
Segall, Samuel 548
Simpson, Victor 919
WHEREAS, Fire District of Sun City West Phase I has a pulation of fifteen
hundred or more;
NOW, THEREFORE, BE IT RESOLVED that the said Fire District of Sun City
West Phase I is hereby declared organized; that Charles A. G eyer, Dolores Lowe,
Victor Simpson, James Maley, and Tony Barraco, be declared ele cted as the Board of
Directors of Sun City West Fire District; and that the bounder ies of the said Fire
District be declared as follows:
Beginning at the point of intersection of the Northeasterly right-of-way line of
the Atchison, Topeka and Santa Fe Railroad with the Eas -erly line of Section
Three (3), Township Three North (T3N) Range One West (R1W), same being one-
half 00 the width of Dysart Road Westwardly of the boundar r line of the Town of
Surprise at that point, thence Northwardly along said Easter y line of said Sec. 3,
to the common corner of said section with Section 2, T3N, R1W, Sections 34 ot
35, T4N, R IW, said point being near the point of intersectior of the centerline of
Bell Road, with the center line of Dysart Road, thence Ea rterwardly along the
South line of the aforementioned Section 35 to the South:ast corner thereof,
same being near the point of intersection of the centerline c f Bell Road with the
center line of El Mirage Road, thence Northwardly with EL Mirage Road along
the Easterly line of Sections Thirty-five (35), Twenty-six (26) and Twenty-three
(23) to the Northeast corner of said Section 23, said point being near the point of
intersection of the centerline of El Mirage Road with tht centerline of Deer
Valley Drive, thence Westwardly with Deer Valley Drive alaig the Northerly line
of Sections Twenty-three (23), Twenty-two (22), Twenty-o (21), Twenty (20)
and Nineteen (19) to the point of intersection of said northerly line of Section
Nineteen (19) with the Northeasterly line of the aforemt ntioned ATdc5F RR
right-of-way; thence Southeastwardly following said right-of-way line across
portions of Sections Nineteen (19), Twenty (20), Twenty-nine (29), Twenty-eight
(28), Thirty-three (33) and Thirty-four (34), T4N, R LW and continuing
southeastwardly along said right-of-way line across a portion of Section Three (3)
to the East line of said Section Three (3), T3N, R1W, to the point of beginning,

By Order of the Board of Supervisors this 4th day of May, 19 1.
BOARD OF SUPERVISORS
MARICOPA COUNTY!, ARIZONA
ATTEST;
Rhe Woodall, Clerk

...Caring People Providing Quality Service
SUN CITY WEST FIRE DISTRICT
18818 N. Spanish Garden Drive, Sun City West, Arizona 85375
Business: (623) 544-5400 — Fax: (623) 544-5455 — www.sewfire.org
March 31, 2015
Mrs. Selena Castaneda
Fort McDowell Yavapai Nation Tribal Council Secretary
P.O. Box 17779
Fountain Hills, AZ 85269
RE: Fort McDowell Yavapai Nation Grant Application 2015
Dear Mrs. Castaneda:
The Sun City West Fire District is requesting assistance from the Fort McDowell Yavapai Nation
Grant Program. The District is grateful that the Fort McDowell Yavapai Nation realizes the value
of Arizona's public safety services and is willing to provide assistance in the provision of those
services. This is the first time that Sun City West will be applying for your grant program.
The Fire District is committed to providing public safety services to Sun City West and its
surrounding communities. If this grant request if funded, the requested equipment will greatly
enhance the District's ability to continue to provide critical services and continue our
commitment to serving the citizens of not just our community, but the entire state.
The requested funding will be used to purchase Electronic Patient Reporting Hardware (portable
computers). This hardware is a vital component for treating and documenting critically ill and
injured patients and ensuring that they receive adequate emergency medical care.
Our hope is that, with your assistance, we will be able to fund this project to enhance the quality
of services that we provide to the communities we serve.
RB:tvs
C.J14 1,tr :xi:, :7 9..is 71
: ':,o1 - • : • (24111..

Fort McDowell Yavapai Nation Grant Application 2015
Name and Contact information for entity that will accept and disburse funds:
Maricopa County
Board of Supervisor's Chairman — Steve Chucri
301 W. Jefferson Street
Phoenix, AZ 85003
Organization Contact Information:
Sun City West Fire District
Application Contact Person — Tim Van Scoter, Assistant Chief
18818 North Spanish Garden Drive
Sun City West, AZ 85375
623-544-5400
tvanscoter@scwfire.org
Narrative
The Sun City West Fire District serves the northwest portion of the Phoenix Metropolitan area with 142
uniformed, civilian and volunteer employees. The District was formed in 1981 and has grown to protect
roughly 45,000 residents within a roughly 45 square mile area. Approximately 77% of our population is
senior citizens residing in the retirement community of Sun City West. The District provides fire
protection, emergency medical service (EMS) and public assistance/non-emergency services to the Sun
City West retirement community and surrounding areas. The District is a unique entity, which has a
history of using an innovative and proactive approach to delivering excellent quality and highly efficient
services to its residents. In 2014, the Fire District responded to approximately 8,800 calls for assistance
and transported over 4,000 patients to the hospital.
Upon the completion of a new fire station under construction in a recently annexed portion of the District,
our services will be provided from 4 strategically located fire stations. The requested grant equipment
would primarily be used to serve this newer area of the District by outfitting a paramedic engine and two
ambulances with Emergency Patient Reporting Hardware for properly treating and documenting critically
ill and injured patients, ensuring they receive the best care possible.
Description of the Proposed Project for Funding
The proposed project involves purchasing and equipping 1 paramedic engine and 2 paramedic
ambulances with Electronic Patient Care Reporting (ePCR) tablet computers. We are currently building a
new fire station in a newly annexed and growing area of the District. The 3 requested ePCR tablets
would be used daily by the crews to provide EMS services to the community. The ePCR system allows
for documentation to go on continuously throughout the emergency call, produces more comprehensive
and accurate reports, improves protocol compliance, and enhances productivity with a quicker return to
service for our crews. The proposed project will directly benefit citizens in the District, in neighboring
communities and throughout the state through mutual and automatic aid responses.
Description of how the proposed project meets one or more of Fort McDowell's funding priorities.
As a public safety organization, the requested grant funding by the Sun City West Fire District directly
satisfies the priority funding area focus on Health and Public Safety as outlined.
Identification of the need grant will address, target population and number of people to be served
by the project.
Funding for the 3 ePCR tablets would enhance our ability to serve the 45,000 residents of our District, as
well as our automatic-aid consortium partners. The consortium includes 27 departments working together
as a unified network of responders. Collectively, we protect over 2,000 sq. miles and provide services to

nearly 4 million citizens. Last year alone, the District responded to assist neighboring jurisdictions nearly
1,000 times. The ePCR system currently in use provides our paramedic's with technology that allows for
the best care possible for patients treated and transported to the hospital. Our capital funding is limited
and has been dedicated to the new station and to the purchase of the required fire apparatus and
ambulances. The assistance with the ePCR hardware would ensure that our crews have the tools
necessary to continue to deliver the best EMS care possible.
Description of partners in the project; other entities providing funding and support. Applications
or awards granted by other tribes/nations.
There are no other organizations, partners or funders directly participating in the development of this
particular project. The District has developed this project to meet the needs of our Fire District and its
residents. However, as stated, this project will greatly benefit many citizens outside of our District
boundaries through our EMS services being provided throughout the Valley via our existing automatic-
aid agreements.
This is the first time that the Sun City West Fire District has applied for the Fort McDowell Yavapai Nation
Grant program or any other tribal grants. The District has never received funding from any tribal/state
shared revenue grant programs. The Fort McDowell and other tribal gaming facilities are well supported
by the citizens of the Sun City West retirement community and we look forward to working with you on
this project.
Timetable for implementation of the project.
The proposed timeline set for this project would tentatively set a start date of July 1, 2015 or the date the
project is funded through your grant program. The finish date would be on or before June 30, 2016 (the
end of our fiscal year). The timeline is flexible and the District would be open to any timeline or changes
necessary to meet your program funding requirements.
Long-term funding and sustainability beyond the grant period.
The requested equipment will be used daily by our EMS crews. Any and all costs of maintaining and
operating these devices, including ePCR software, will be the responsibility of the District and will be
programmed into our annual operating budget. The sustainability of this project would be for the entire
life of the equipment, which is expected to exceed 5 years.
The District's current budget lacks the funds for the initial capital outlay without diverting funds from other
critical programs. The District is primarily funded by property taxes. Recent legislative changes make it
very difficult for fire districts to increase revenue. In addition, the Sun City West Fire District was hit
particularly hard by the recent recession and is not projected to return to pre-recession secondary
property value levels for at least another decade.
BUDGET
. Amount Requested From , .r's In Kind Contributions , -
Fort McDowell Yavapai Nation Provided by The ''., , -.- - Total Project ..
Fire District of Sun City West
3 Each ePCR Computing Tablets Programing, Maintenance
Agreement and Accessories
$10,260 $1,740 $12,000