The recipient entity's physical address:
           1446 4th Street
Saline, LA 71070

The recipient entity's mailing address (if different):
           200 J Brown Road
Saline, LA 71070

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Religious Corp.

If the entity is a corporation, list the names of the incorporators:
          LeDean Roberts
Sheri Keel Roberts

The last four digits of the entity's taxpayer ID number:  2760

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

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:
           Janet Martin, Board Member
PO Box 210
Hodge, LA 71247

Vickie Ponder, Board Member
6160 Hwy 155
Saline, LA 71070

Tina Kay, Board Member
340 Cemetary Road
Castor, LA 71016

LeDean Roberts, Director
Sheri Keel Roberts, Director, Secretary/Treasurer

Provide a summary of the project or program:
           New roof and completion of ongoing major repairs to renovate outdated building for use as a youth center for meetings and recreational activities for at-risk youth. To provide a safe supervised place for at risk youth who are vulnerable to juvenile crime and substance abuse.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $150,000
          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?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          To provide a facility to support mentoring and guidance for at risk youth who are facing challenges such as substance abuse, teenage pregnancy, and conflicts. Activities to include mentoring, character training, recreation, bible studies, bible distributions, and other faith-based activities particularly on weekends when youth are more vulnerable to crime, substance abuse, and conflicts.

What are the goals and objectives for achieving such purpose?
          To complete the building to provide a facility to support and guide the at-risk youth in Saline and the surrounding areas who are vulnerable and are subjected to poverty, crime, substance abuse, and family dysfunction. To produce young men and women of character, good morals, and values to become productive members of society.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           With funding, facility completion expected by Fall of 2026.

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? 

(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:  Sheri Roberts 
                                       address:  200 J Brown Road
Saline, LA 71070
                                       phone:  318-245-0961
                                       fax: 
                                       e-mail:  srob3638@yahoo.com
                                       relationship to entity:  Director; Secretary/Treasurer