SRPMIC 2013 12% APPLICATION SUBMITTED.PDF
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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: 06/12/2013 Organization Name: Veterans Medical Leadership Council (VMLC) Organization/Municipal Government Street & Mailing Address: VMLC Charities 3627 East Indian School Road, Suite 209 Phoenix, AZ 85018 Contact Person and Project Manager if different from Contact Person: Col. Sam Young, Ret. Title: President, VMLC Address: same as org Phone: (602) 540-7648 Fax: Email Address: info@arizonavmlc.org Project Name: Returning Warrior Fund (RWF) In 200 words or less, please provide a brief description of the project submitted to the 12% SRPMIC Grant program. As our brave service men and women return home from combat, they often face barriers and challenges while rejoining civilian life. For those veterans who receive case management services from the Phoenix VA Hospital, the Returning Warrior Fund provides immediate assistance needed in order to ensure stability and success. The RWF provides financial assistance with rent, utilities, transportation (including auto repairs), food, medical (treatment and prescriptions), and other material needs. The goal of the program is to allow veterans and their families to remain in their homes, food on the table, and a reliable vehicle so the veteran can focus on healing. Beginning Date of Project: ongoing (existing) End Date of Project: ongoing (existing) Geographic Area to be served: Maricopa County (primarily), but RWF serves all AZ Veterans ** Attach Detailed Budget** Amount of Total Project: $400,000 Amount of 12% Request: $100,000 (No Multi-Year Request will be accepted) 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): Because VMLC is operated by all volunteers, the RWF is able to run a virtual zero budget, requiring only $1,000 for administrative services of a bookkeeper. Any amount of funding received will be used directly and entirely to serve AZ Veterans experiencing a financial crisis. If you receive SRPMIC 12 % funding, will it be spent (Check One): Monthly (as needed) Quarterly 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 2012-2013 12% cycle. 2012: $75,000 2011: $100,000 2010: $100,000 2009: $175,000 2008: $150,000 2007: $100,000 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.) Material support to AZ Veterans in financial crisis B.) C.) D.) Which municipal governmental entity will serve as your pass through or accept 12% funds on your behalf? City of Tempe 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. 06/12/2013 Signature for the Applicant Date Sam Young, President, VMLC 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.