NGO Funding Request


The recipient entity's full legal name:  LaSallle 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, Louisiana 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:
           Steve Andrews, P. O. Box 644, Jena, LA. 71342, Wanda Burlew, P. O. Box 1811, Jena, La. 71342, Walter Craig, 138 Cole Warren Lane, Jena, LA.,71342 Carla Crocket, P. O. Box 327, Trout, LA, 71371, Steve Crooks, P. O. Box 3008, Jena, LA. 71342, Bonita Franklin, P. O. Box 3050, Jena, LA. 71342, Secretary, Barbara Germany, 161 Verna Drive, Jena, LA. 71342, Sue Gibbs, P. O. Box 1116, Jena, La.,71342 President, Mattie McCarroll, 5794, Hwy. 127 North, Olla, LA. 71465, Wayne Richardson, 4224 Austin Road, Jena, LA, 71342, Bruce Wilson, P. O. Box 1888, Jena, LA. 71342, Vice-President

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 maintain their independence 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 & Assistance, Group Respite, Telephoning and Outreach. Cooperates with local agencies in the Food for Seniors, Farmer's Market Produce and is a referral agency for med-alert.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $40,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $20,000
          Major Repairs . . . . . . . $40,000
          Operating Services. . . . $0
          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 to help them remain 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 to doctor's visits, to purchase medications and food.

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 & Assistance, Group Respite, Outreach, Telephoning, To be used to support available programs hire an additional staff member and to provide a service to purchase 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