Grant Request

Coconino CASA for Kids appreciates all you do for the vulnerable population involved in the child welfare system. We want to help reduce the hardship and anxiety stemming from difficult and often traumatic circumstances. We are here to help the following groups with basic needs and wants, including orthodontics:

1. A child or youth aged 0-21 with a dependency originating within Coconino County, regardless of where the child or youth is placed.

2. A child or youth aged 0-21 placed in Coconino County but with a dependency in an Arizona county other than Coconino County.

3. A child or youth aged 0-21 that DCS has identified as at risk and needing support to prevent a dependency; and,

4. A young adult who aged out of the DCS system but is continuing to receive support from DCS.

5. CCFK will also help families living in Coconino County with the safety equipment needed to become a licensed foster care home.

Grant Request Form

Last Name of Child Benefiting from this request

First Name of Child Benefiting from this request

Age of child

Gender of Child

Are there additional children to add?

Last Name of Additional Child

First Name of Additional Child

Age of Additional Child

Gender of Additional Child

Type of Placement for Additional Child

Type of Placement

Requester's Name

Requester’s phone number

Requester's Email

Requester's Relationship to Child

DCS case manager name

Amount Requested

Please Choose an Option for Gift Card

Delivery of gift card

Please provide an explanation for this request

If an e-gift card, please list name of recipient

Recipient’s email

Date gift card is needed

Additional Notes

Please note:

Some examples of basic needs and wants: food, clothing, school supplies, phones for visitation, laptops for school, and bicycles and safety gear. CCFK will also fund household expenses for kinship families, as deemed necessary.
Approved requests will typically be filled with a physical gift card delivered to the DCS office in Flagstaff or to the receptionist at Coconino Juvenile Court on Sawmill. An electronic gift card can be sent in situations when distance and urgency require one. Applicants will be notified of a final decision as soon as possible. Please allow 72 hours for the delivery of gift cards for normal requests.
A request of $225 for a three month supply of diapers and formula can be made quarterly and will be approved automatically.
Requests for assistance can be submitted by a CASA, GAL, DCS staff, JPO, child’s attorney, child’s therapist, foster parent (must present Notice to Provider), or foster care licensing agent.
If you apply for assistance with orthodontics, we need a copy of the treatment plan and payment plan from the orthodontist. This review will take longer than for other grant requests.
Other sources of funds for basic needs and wants are: Arizona Friends of Foster Children Foundation, AZ 1.27 (the care portal) and Helping Hands.