The recipient entity's physical address:
           *** Confidential Address ***

The recipient entity's mailing address (if different):
           P.O. Box 1401
Lake Charles, La 70602

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:  9095

What is the dollar amount of the request?  $125,000

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:
           Jarome Davis
631 Mosswood Drive
Conroe, Tx 77302

Markell Williams
1939 Owen Dr.
Lake Charles, La 70601

Robert Collins
5620 Emerald Dr.
Lake Charles, La 70615

Provide a summary of the project or program:
           Lake Area Foundation of Kappa Alpha Psi purpose is to mentor young men into being successful adults. One of the initiatives that we explore is with the Mental Health and wellness of the young men. We also train the young men through a series of College Prep materials, conferences, and college visit. We encourage Social action and require community service. Overall, we provide additional train to young men who need to see what success looks like.

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. . . . $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?
          The state funds will allow Lake Area Foundation of Kappa Alpha Psi to continue operations and expand enrollment. It will allow for more visit to state charter Universities. It will provide funds that will help increase our opportunity to provide community service to Calcasieu parish.

What are the goals and objectives for achieving such purpose?
          The goal is to guide young men in the right direction to a successful life. Our objective is to show young men that they can Achieve what they believe and model what success looks like.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           4 years ( High School)

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:
                 NONE
    
     (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:
                 NONE

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 0

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  NONE

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: 
               NONE

(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:
               NONE

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

          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:  Robert Collins 
                                       address:  5620 Emerald Drive
Lake Charles, La 70615
                                       phone:  3379361636
                                       fax: 
                                       e-mail:  robertqc2@gmail.com
                                       relationship to entity:  Officer