The recipient entity's physical address:
           11404 Lake Sherwood Drive, Suite B, Baton Rouge, LA 70816

The recipient entity's mailing address (if different):
           11404 Lake Sherwood Drive, Suite B, Baton Rouge, LA 70816

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:  0993

What is the dollar amount of the request?  $250,000

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:
           KATHY VICTORIAN
Title: President
Address 1: 11404 LAKE SHERWOOD AVE N.
Address 2: SUITE B
City, State, Zip: BATON ROUGE, LA 70816
Officer: LAUREN FOWLER
Title: Vice-President
Address 1: 11404 LAKE SHERWOOD AVE N.
Address 2: SUITE B
City, State, Zip: BATON ROUGE, LA 70816
Officer: JADA LEWIS
Title: Director
Address 1: 11404 LAKE SHERWOOD AVE. N
Address 2: SUITE B
City, State, Zip: BATON ROUGE, LA 70816
Officer: STAFFORD WOOD
Title: Director
Address 1: 11404 LAKE SHERWOOD AVE. N.
Address 2: SUITE B
City, State, Zip: BATON ROUGE, LA 70816
Officer: KRISTI RICHARD
Title: Secretary/Treasurer, Director
Address 1: 11404 LAKE SHERWOOD AVE. N.
Address 2: SUITE B
City, State, Zip: BATON ROUGE, LA 70816

Dianna Payton, Chief Executive Officer, James Gilmore, COO, and Melissa Hayes, CFO (11404 Lake Sherwood Avenue, North, Baton Rouge, LA 70816

Provide a summary of the project or program:
           Project will provide funding for youth development, adult development, and community development acitivites and services in East Baton Rouge Parish. The programming will work to decrease crime, increase literacy, build a stonger workforce, improve educational outcomes of citizens, provide health and wellness assistance, and more.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $25,000
          Professional Services. . . $50,000
          Contracts . . . . . . . . . . . $150,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $15,000
          Other Charges. . . . . . . $10,000

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 decrease crime, improve adult literacy, promote health and wellness, develop a stronger workforce, etc.

What are the goals and objectives for achieving such purpose?
          Offer Crime Prevention Programming and Training such as Conflict Resolution and Street Teams to engage youth and adults in healthy discssions to resolve differences.

To provide adult literacy and job training services, in cluding referrals to jobs and job training institutions.

Educate citizens on eating healthy and disease prevention and management

What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 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:
                 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:
                 NONE

     (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:
                NONE

          What is the nature of the relationship?  NONE

(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:
                 NONE

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               NONE


Contact Information
name:  Dianna Payton 
                                       address:  11404 Lake Sherwood North, Suite B., Baton Rouge, LA 70816
                                       phone:  2252008881
                                       fax: 
                                       e-mail:  paytond@ywca-br.org
                                       relationship to entity:  CEO