GIRL SCOUTS - AZ CACTUS-PINE APPLICATION - SRPM 2014.PDF

Admin Tribe Selection
Created Thursday, October 23, 2014
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Please select to which tribe this Organization has applied to:
Salt River
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Created Friday, October 24, 2014
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General information
General information | Organization Girl ScoutsDArizona Cactus-Pine Council
General information | Contact First name Katie
General information | Contact Last name Penkoff
General information | Contact e-mail kpenkoff@girlscoutsaz.org
General information | Contact phone number 6024527164
Address
Address | Street 119 E. Coronado Road
Address | City Phoenix
Address | State Arizona
Address | ZIP Code 85004
What is the name of the program or project for which your organization is requesting grant
funds?
Leadership Center for Girls in Arizona
For what grant amount does the organization plan to request funding?
$20,000
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CO IRS IntemMR.vvenueSenice DepartmentatheTreasury
P.O. Box 2508 In reply refer to: 0248364799
Cincinnati OH 45201 Aug. 23, 2012 LTR 4168C ED
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 Humber: 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.

0248364799
Aug. 23, 2012 LTR 4168C EO
86-0133397 000000 00
00018173
GIRL SCOUT COUNCIL INC-ARIZONA
CACTUS-PINE
119 E CORONADO RD
PHOENIX AZ 85004-1512
If you have any questions, please call us at the telephone number
shown in the heading of this letter.
Sincerely yours,
;0414'40,401(5A4e4.—
Richard McKee, Department Manager
Accounts Management Operations

SALT RIVER PIMA-1VIARICOPA
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: June 20, 2014
Organization Name: Girl Scouts—Arizona Cactus-Pine Council
Organization/Municipal Government Street & Mailing Address: 119 E. Coronado Road, Phoenix, AZ
85004
Contact Person and Project Manager if different from Contact Person: Kristie Leshinslde
Title: Advancement Officer
Address: 119 E. Coronado Road, Phoenix, AZ 85004
Phone: 602/452-7088
Fax: 602/452-7100
Email Address: kleshins kie(&,gi risco utsaz.o rg
Project Name: Leadership Center for Girls in Arizona
In 200 words or less, please provide a brief description of the project submitted to the
12% SRPMIC Grant program.
The Leadership Center for Girls is a landmark facility on the 14-acre site of the Girl Scouts' Camp
Sombrero in South Phoenix, at the foot of South Mountain. The Leadership Center will have the
capacity for 300 girls or adult volunteers, and will provide opportunities for girls across Arizona to
gather for programs. The Leadership Center and accompanying Camp Sombrero 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.
Specifically, this request is to fund the prominent Girl Scout Tower in front of the Leadership
Center's Volunteer Resource Center & Council Shop, as well as two of the Girls' Outdoor
Experience Areas within the camp's cabin clusters. The Girl Scout Tower is a permanent display
adjacent to the high-traffic Volunteer Resource Center and retail store, both frequented by adult
volunteers/girls. The Girls' Outdoor Experience Areas are the common areas where campers/Girl
Scout troops will gather for physical activity/group work. Both the Tower and the Outdoor
Experience Areas will be named in honor of the SRPMIC, and will be recognized on the main
Donor Wall on the Leadership Center campus.

Beginning Date of Project: End Date of Project:
December 1, 2014 November 30, 2015
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 $250,000
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):
The total Campaign for Girls in Arizona budget is $15 million, including $10 million for the
Leadership Center and Camp Sombrero renovations, and $5 million for complementary programs
including outreach to tribal, Latina and faith-based populations.
Of the $10 million required for construction, our board determined that $7.5 million must be raised
prior to groundbreaking. The Girl Scouts have currently raised $4.1 million to date, with more
than $16 million in pending requests. We also have strong indications from two local foundations
that they will support the project.
Specific to this request, though, we do not have any other requests pending for the Tower and
Outdoor Activity Areas.
If you receive SRPMIC 12 % funding, will it be spent (Check One):
O Monthly
D Quarterly
X Lump Sum
List of SRPMIC 12% funds you have received in the past and a list of other 12 % grants funding you are
seeking from other Tribal Governments for the 2013-2014 12% cycle.
Other SRPMIC 12% funds received:
-Social Just Us (Baby Camp, Girl Scouts Beyond Bars, etc.,) December 2012, $20,000
-Campaign for Girls in Arizona, December 2013, $20,000
Other 12% grants requested:
-Leadership Center for Girls, Gila River Indian Community, $500,000
-Leadership Center for Girls, Fort McDowell Yavapai Indian Community, $10,000
-Leadership Center for Girls, Tohono O'odham Nation, $50,000
List any other funds you have received from the SRPMIC 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.) Salt River Pima-Maricopa Indian Community Tower at Volunteer Resource Center ($100,000)
B.) Salt River Pima-Maricopa Indian Community Outdoor Experience Area #1 ($75,000)
C.) Salt River Pima-Maricopa Indian Community Outdoor Experience Area #2 ($75,000)
D.)
Which municipal governmental entity will serve as your pass through or accept 12% funds on your
behalf?
In years past, the Girl Scouts have worked with the City of Mesa as a pass through for Salt River
Pima-Maricopa Indian Community 12% funds. We have also worked with Maricopa County as a
pass through for other 12% funds, and welcome the opportunity to work with the City of Mesa or
Maricopa County in the future.
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.
June 20, 2014
Signature for the Applicant Date
Chief Financial and Operating 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.