The recipient entity's physical address:
           222 Mayo Street
Lafayette, Louisiana 70501

The recipient entity's mailing address (if different):
           222 Mayo Street
Lafayette, Louisiana 70501

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

If the entity is a corporation, list the names of the incorporators:
          Carole Glover
Debra Lavergne
Denver Nobles

The last four digits of the entity's taxpayer ID number:  1388

What is the dollar amount of the request?  $30,000

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:
           President Jennifer Randal-Thorpe 222 Mayo Street Lafayette, Louisiana 70501
Secretary Sharon Jones 4608 Hazard Road New Iberia, Louisiana 70560
Treasurer Carolyn Edwards 804 Fairmont Lane Lafayette, Louisiana 70501

Provide a summary of the project or program:
           The purpose of this grant is to finance existing operations of this organization. To include existing programs currently provided by this organization to individuals with mental health and or substance use disorders their families and the community. This is accomplished by providing educational, awareness and recognition programs for individuals with behavioral health disorders.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $5,000
          Contracts . . . . . . . . . . . $17,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $800,000
          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?
          Yes

What is the entity's public purpose, sought to be achieved through the use of state monies?
          The mission of this organization is to provide direct peer support, educational and awareness programs to individuals with mental health and or substance use disorders their families and the community.

What are the goals and objectives for achieving such purpose?
          The goals of this organization are to facilitate monthly educational programs virtually or in person. Recognize six awareness campaigns statewide, i.e., National Crime Victims' Rights Week, National Domestic Violence Month. World Peer Support Month, Mental Health Awareness Month, Suicide Prevention Week, National Minority Mental Health Month, and National Recovery Month. By achieving these goals, we will increase awareness of the prevalence of behavioral health disorders and decrease stigma associated with living with these disorders.

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

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:
                 Jennifer Randal-Thorpe 222 Mayo Street Lafayette, Louisiana 70501
    
     (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:
                 100%

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  Chief Executive Officer/President

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:  Jennifer Randal Thorpe 
                                       address:  222 Mayo Street
Lafayette, Louisiana 70501
                                       phone:  3379094655
                                       fax: 
                                       e-mail:  meaningfulmindsunited@gmail.com
                                       relationship to entity:  CEO/President