NGO Funding Request


The recipient entity's full legal name:  Maddie's Footprints

The recipient entity's physical address:
           104 Westmark Blvd.
Lafayette, LA 70503


The recipient entity's mailing address (if different):
           PO Box 404
Youngsville, LA 70592


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

If the entity is a corporation, list the names of the incorporators:
          

The last four digits of the entity's taxpayer ID number:  4830

What is the dollar amount of the request?  $200,000

What type of request is this?  General Appropriation

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:
           Lori McGrew-Chairman and Co-Founder, 205 Chevalier Blvd. Lafayette, LA 70503
Frank Slavich-Vice-Chairman, 507 Cypress Cove Youngsville, LA 70592
Amber Trett-Treasurer P.O. Box 716 Duson, LA 70529
Mandie Harrington-Secretary 6160 Johnston St. Lafayette, LA 70503
Travis McGrew-Co-Founder, 205 Chevalier Blvd. Lafayette, LA 70503
David Binnings 7217 Swallow Branch Ln Plano, TX 75025
Aundria Cannon 116 Montero Circle Lafayette, LA 70503
Mike Collado 111 Oak Forest Dr. Lafayette, LA 70501
Emily Hunter 123 Metarie Court Lafayette, LA 70503
Andrea Landry 206 Winchase Dr Lafayette, LA 70508
Lauren Bercier 322 Hwy 1252 Carencro, LA 70520
Fallon Guidry 1021 Cory Rd Breaux Bridge, LA 70517
Amanda Alleyn 514 Woodvale Ave Lafayette, LA 70503
David Kaplan 705 Peak Run    Youngsville, LA 70592
Matthew Thibodeaux 215 Versailles Blvd #3 Lafayette, LA 70501
Hailey Verret 5215 N. University Ave. Lot 4 Carencro, LA 70520


Provide a summary of the project or program:
           The mission of Maddie’s Footprints is to provide support to families coping with miscarriages, stillbirths or the loss of an infant. Since the organization was founded in 2010, Maddie’s Footprints has served over 900 families in a 10 parish region of Acadiana. This request is to help fund operational expenses for the organization including staff salaries and its Infant Loss Program. This program provides financial assistance for medical expenses such as hospital/medical bills for still births, D&C procedures, or other medical bills incurred before an infant’s death. The program also assists families with funeral expenses for infant deaths up to one year of age. Due to the growth of this program and the need in Acadiana, the average amount of families served has increased to nearly 200 annually. The Infant Loss program is vital to the community since there is not another organization in the Acadiana region providing this program and other similar and necessary grief support services. This funding will allow Maddie’s to continue offering assistance to these families.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $77,500
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $125,000
          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?
          . This request is to help fund operational expenses for the organization including staff salaries and its Infant Loss Program. This program provides financial assistance for medical expenses such as hospital/medical bills for still births, D&C procedures, or other medical bills incurred before an infant’s death. The program also assists families with funeral expenses for infant deaths up to one year of age. Due to the growth of this program and the need in Acadiana, the average amount of families served has increased to nearly 200 annually. The Infant Loss program is vital to the community since there is not another organization in the Acadiana region providing this program and other similar and necessary grief support services. This funding will allow Maddie’s to continue offering assistance to these families.

What are the goals and objectives for achieving such purpose?
          • Approximately 180 local families receive financial assistance for end-of-life expenses such as funeral services, caskets, and burial plots.
• Approximately 20 families receive financial assistance for medical expenses such as hospital/medical bills for still births, D&C procedures, or other medical bills incurred before an infant’s death


What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 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:
                

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

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? 

(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:
                 N/A

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               N/A


Contact Information
name:  Heather Broussard 
                                       address:  PO Box 404
Youngsville, LA 70592

                                       phone:  3182863366
                                       fax: 
                                       e-mail:  hbroussard@maddiesfootprints.org
                                       relationship to entity:  Executive Director