The recipient entity's physical address:
           5160 Oak Bayou Ave
Marrero, LA 70072

The recipient entity's mailing address (if different):
           5160 Oak Bayou Ave.
Marrero, LA 70072

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

If the entity is a corporation, list the names of the incorporators:
          Gail Jackson

The last four digits of the entity's taxpayer ID number:  9670

What is the dollar amount of the request?  $60,000

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:
           Gail Jackson
Executive Director
5160 Oak Bayou Ave.
Marrero, LA 70072

Kimberly Dilosa
Program manager
816 Rupp Street
Gretna, LA 70053

Provide a summary of the project or program:
           Comprehensive community youth prevention and intervention programs and events (2022-23)

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $12,000
          Professional Services. . . $24,000
          Contracts . . . . . . . . . . . $12,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $12,000
          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?
          Service learning education and youth leadership development activities and programs for youth in grades K-12 and their families!

What are the goals and objectives for achieving such purpose?
          1. Teach the importance of social etiquette education among youth.
Objective: Produce a summer enrichment program for youth.
2. Develop young leaders who will make positive contributions to society.
Objective: Produce POWERful Teen Summit to convene youth and engage the youth in community problem solving.
3. Identify and promote existing youth programs in the community that can help keep youth engaged and out of harm's way.
Objective: Produce a community youth program expo to raise public awareness about the existence of these programs.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           12 month

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:  Kimberly Dilosa 
                                       address:  816 Rupp Street
Gretna, LA 70053
                                       phone:  504-473-4602
                                       fax: 
                                       e-mail:  fionproductions@gmail.com
                                       relationship to entity:  Program Manager