NGO Funding Request


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

The recipient entity's physical address:
           965 Hwy 384
Grand Lake
Lake Charles, La. 70607


The recipient entity's mailing address (if different):
           965 Hwy 384
Grand Lake
Lake Charles, La. 70607


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:  8002

What is the dollar amount of the request?  $75,000

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:
           Wilson Lejeune - Chairman - 146 Brents Rd, Bell City, La. 70630
Oscar Reyes Sr. P.O. Box 639, Cameron, La. 70631
Annette Norman 1100 Hwy 384, Lake Charles, La. 70607
Beryl Romero 103 Brazille Daigle Road, Lake Charles, La. 70607
Rosa Lee Bargeman 1481 3d Apt 1457, Lake Charles, La. 70601
Alice Reeves 250 Reeves Lane, Hackberry , La 70645
Helen Warren 10104 Gulf Hwy Apt 128, Lake Charles, La. 70607
Loston McEvers 1519A Hwy 384, Lake Charles, La. 70607
Lee Allen Benoit 10388 Gulf Hwy, Lake Charles, La. 70607
Ina Jane Gaspard P.O. Box 43, Cameron, La. 70631
Kitty Askew 159 Newell Road,Lake Charles, La. 70607
Hazel LaBove 220 Channelview, Hackberry, La. 70645
Betty Seay P.O. Box 178, Hackberry, La. 70645
Kirk Quinn 180 Quinn Lane, Bell City, La. 70607
Wayne Taylor 4794 W. Nick Claire, Iowa 70647


Provide a summary of the project or program:
           The project includes home delivered services such as home delivered meals, caregiver program and homemaker services. These are extremely critical home delivered services provided to persons in extremely rural areas of the parish. There is no local nursing home in the area and persons need care in their own homes, more care than what their families can provide in some instances.

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. . . . $75,000
          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?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          The purpose of the Cameron Council on Aging services is to provide a wide variety of needed in home and community services for persons age sixty and above. These services are needed in order for the senior citizens to remain in the comfort of their own homes and not have to be transported into another parish to a nursing home.

What are the goals and objectives for achieving such purpose?
          The main goal is to provide services that promote healthy living such as a well balanced diet, homemaker services, in home health screening, transportation, medical equipment, nutrition education and a wide variety of other services.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           The agency continues to provide services day after day, year after 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:
                 na
    
     (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:
                 na

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

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

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: 
               na

(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:
               na

          Provide the name, address, and office of the official to whom the person is related:
                na

          What is the nature of the relationship?  na

(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:
                 na

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


Contact Information
name:  Dinah B. Landry 
                                       address:  965 Hwy 384, Lake Charles, La. 70607
                                       phone:  337-532-3030
                                       fax:  337-905-6500
                                       e-mail:  dinahlandry@yahoo.com
                                       relationship to entity:  Executive Director