NGO Funding Request


The recipient entity's full legal name:  LaSalle Council on Aging, Inc.

The recipient entity's physical address:
           LaSalle Council on Aging, Inc.
530 East Bradford Street
Jena, LA. 71342


The recipient entity's mailing address (if different):
           LaSalle Council on Aging, Inc.
P. O. Box 87
Trout, LA. 71371


Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          Eric Brown, Beth Buckhalter, J. E. Cammack, M. A. Elliott

The last four digits of the entity's taxpayer ID number:  3057

What is the dollar amount of the request?  $100,000

What type of request is this?  Both

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Wanda Burlew, P. O. Box 1811, Jena, LA. 71342, Secretary, Walter Craig, 138 Cole Warren Lane, Jena, LA. 71342, Carla Crockett, P. O.Box 327, Trout, LA. 71371, Steve Crooks, P. O. Box, 3008, Jena, LA. 71342, Sammy Franklin, P. O. Box 3050, Jena, LA. 71342, President, Barbara Germany, 161 Verna Drive, Jena, LA. 71342, Sue Gibbs, P. O. Box 1116, Jena, LA. 71342, Donna Justiss, P. O. Box 2990,Jena, LA. 71342, Mattie McCarroll, 5794 Hwy. 127 North, Olla, LA. 71465, Wayne Richardson, 4224, Austin Road, Jena, LA, 71342, Vice-President, Bruce Wison, P. O. Box 1888, Jena, LA. 71342

Provide a summary of the project or program:
           LaSalle Council on Aging provides services to the elderly residents of LaSalle Parish in order to help them be independent and reside in their own homes for as long as possible. Services currently provided are Chore, Home Delivered Meals, Congregate Meals, Recreation, Respite, Sitter, Nutrition Education, Transportation, Information and Assistance, Group Respite, Telephoning, Outreach. Cooperates with local agencies in the Food for Seniors, Farmers Market Produce and is a referral agency for Med Alert.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $35,000
          Professional Services. . . $30,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $35,000
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          Not Applicable

What is the entity's public purpose, sought to be achieved through the use of state monies?
          LaSalle Council on Aging provides services to the elderly residents of LaSalle Parish in order help them to be independent and reside in their own homes for a longer period of time. This funding will help to support available services and to provide additional services including the purchase of eye glasses and hearing aids. Also to provide an additional employee to assist in the provision of services.

What are the goals and objectives for achieving such purpose?
          The ultimate goal is to offer seniors services to help them be able to stay at home. Homebound seniors to receive meals, caregivers to be relieved in the care of family members, transportation for doctor's visits, to purchase medications and food, to be able to communicate with friends and family.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           One year

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 N/A
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 N/A

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 N/A

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  N/A

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               N/A

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               N/A

          Provide the name, address, and office of the official to whom the person is related:
                N/A

          What is the nature of the relationship?  N/A

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 Governor's Office of Elderly Affairs
P.O. Box 61
Baton Rouge, LA. 70821-0061


(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               Social services delivered to the elderly population of LaSalle Parish, Home Delivered Meals, Congregate Meals, Sitter, Respite, Chore, Recreation, Nutrition Education, Information and Assistance, Group Respite, Outreach, Telephoning. To be used to support available programs, hire an additional staff member and to provide services purchasing eye glasses and hearing aids for seniors.


Contact Information
name:  Polly Duncan 
                                       address:  P. O. Box 87
Trout, LA. 71371

                                       phone:  318 992-4708
                                       fax:  318 992-4728
                                       e-mail:  lascoa@centurytel.net
                                       relationship to entity:  Executive Director