NGO Funding Request


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

The recipient entity's physical address:
           104 Port Street
DeRidder, Louisiana 70634


The recipient entity's mailing address (if different):
           P.O. Box 534
DeRidder, La. 70634


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

If the entity is a corporation, list the names of the incorporators:
          Kerri Broussard- President
Tonya Craig- Vice President
Julie Robinson- Secretary/Treasurer


The last four digits of the entity's taxpayer ID number:  4475

What is the dollar amount of the request?  $50,000

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:
           Kerri Broussard-1205 Diewart St. DeRidder, La. 70634
Tonya Craig- Allen Street DeRidder, La. 70634
Julie Robinson- 808 Chinquapin St. DeRidder, La. 70634
Connie Granger- 255 Gordy Lane, DeRidder, La. 70634
Joy Lindsay- 11347 Hwy 171 Longville, La. 70652


Provide a summary of the project or program:
           Beauregard Council on Aging provides a wide variety of services for the elderly, 60 years of age and older, residing in Beauregard Parish. Programs such as Home Delivered meals, Transportation, Congregate Meals, Information and Assistance, medical alert systems, material aid, in home respite and sitter services, wellness, and much more.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $50,000
          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?
          Many of the seniors live alone, have no children to check on them,have no means to get to the doctor if they have appointments,to the grocery store to buy their food,or to the drug stores to get their medication.Many are in need of social services to keep them active and in their own homes as long as they are physically able.
The monies will be used to transport them to the necessary appointments to get their medication, see their doctors on a regular basis, and go the grocery store for their food. Also they will delivered a meal if they are home bound and cannot go to the congregate sites to eat their meals.Well balanced nutritional hot meals are delivered five days a week for the noon meal 250 days of the year. All services will be provided to them as needed for their well being.


What are the goals and objectives for achieving such purpose?
          To strengthen all services provided and to offer new services that will increase their independence and well being, while keeping them safe and comfortable.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           One (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:
                 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:
                 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:  Connie L. Granger 
                                       address:  104 Port Street
DeRidder, La. 70634

                                       phone:  337-463-6578
                                       fax:  337-463-7431
                                       e-mail:  clgbeaucoa@bellsouth.net
                                       relationship to entity:  Executive Director