The recipient entity's physical address:
           101 Bocage Drive, Donaldsonville, LA 70346

The recipient entity's mailing address (if different):
           PO Box 412, Donaldsonville, LA 70346

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:  6386

What is the dollar amount of the request?  $500,000

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:
           Thomas Martinez, Chairman, 13367 Hwy. 431, St. Amant, LA 70774, Lisa Bacala, Vice-Chair, 37394 La. Hwy. 621, Prairieville, LA 70769, Sheri Fair, Secretary, 1327 E. Angela St., Gonzales, LA 70737, Raymond Aucoin, 220 E. Bayou Rd., Donaldsonville, LA 70346, Christopher Bridges, 42045 Betty St., Gonzales, LA 70737, Donald Capello, 390560 Driftwood Crossing Ct., Prairieville, LA 70769, Justin Champlin, 36278 Bluff Heritage Ave., Geismar, LA 70734, Tammy Dale, 2407 Mark Ct., Donaldsonville, LA 70346, Elisa Foret, 914 Mulberry ST., Donaldsonville, LA 70346, Jessica Geason, 2320 S. Edwards Ave., Gonzales, LA 70737, Leslie York Jackson, 2306 Twin Circle Dr., Gonzales, LA 70737, Barbara LeBray, 15283 West Bayou Dr., Prairieville, LA 70737, Verna Lemon, 116 Melrose Drive, Donaldsonville, LA 70346, Chase Melancon, 45092 Hwy. 429, St. Amant, LA 70774, Cathy Roach, 43217 Sycamore Bend Ave., Gonzales, LA 70737

Provide a summary of the project or program:
           This funding will be used to help build a senior wellness center in Prairieville to serve that area and alleviate the overcrowding at our Gonzales Centers.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $500,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          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?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          Ascension Council on Aging provides supportive services to allow senior citizens to remain in their homes and age with dignity. This funding will help us to achieve our goal of helping all seniors in Ascension Parish by expanding our centers to serve the Prairieville area and alleviate the overcrowding at our Gonzales centers.

What are the goals and objectives for achieving such purpose?
          To provide a fully functional meal site, wellness center and senior center for the Prairieville community
1. To provide congregate meals to senior citizens
2. To provide an opportunity for socialization
3. To provide educational opportunities
4. To provide recreation activities
5. To provide wellness programs to keep seniors healthier thus delaying their need for our more costly in-home programs.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           Construction will start later this year and hopefully completed in 2025

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:
                
    
     (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:
                

     (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: 
               

(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:
              

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

          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:
                

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


Contact Information
name:  Darlene Schexnayder 
                                       address:  P.O. BOX 412, Donaldsonville, LA 70346
                                       phone:  2257153352
                                       fax:  225-473-1387
                                       e-mail:  darlenes@ascensioncoa.org
                                       relationship to entity:  Executive Director