The recipient entity's physical address:
           2833 ROBINSON STREET
Monroe, LA 71202

The recipient entity's mailing address (if different):
           pastorsmith03@yahoo.com

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

If the entity is a corporation, list the names of the incorporators:
          Jamie Mayo
Juanita Rambo
Rose Lee
Larry Jefferson
LaQuita Danna
Teresia Dickerson

The last four digits of the entity's taxpayer ID number:  1911

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

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:
           James Mayo - 3710 Dunlop St. Monroe, LA 71202
Juanita Rambo - 2907 Cuba Blvd - Monroe, LA 71201
Larry Jefferson - 6511 Cypress Point Drive - Monroe, LA 71203
LaQuita Danna - 502 Eason Place - Monroe, LA 71201
Rose Lee - P.O. Box 650 - Monroe, LA 71210
Teresia Dickerson - 2805 Cuba Blvd - Monroe, LA 71201

Provide a summary of the project or program:
           General Appropriation to fund General Expenses
to provide Educational Services

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $183,100
          Professional Services. . . $6,350
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $2,500
          Major Repairs . . . . . . . $15,000
          Operating Services. . . . $22,000
          Other Charges. . . . . . . $21,050

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?
          Provide Job and Life Skills Training to participants who are primarily low-to-moderate individuals, and who are either disadvantaged, unemployed, and/or under-employed.

What are the goals and objectives for achieving such purpose?
          Provide four (4) classes to eligible individuals by June 30, 2022
2. Provide virtual instruction to 60 students by June 30, 2022
3. Provide Job Readiness and Life Skills Training to 75 students by June 30, 2022

What is the proposed length of time estimated by the entity to accomplish the purpose?
           Twelve 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:
                
    
     (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:  William Smith 
                                       address:  202 Mayhaw Street
Monroe, LA 71203
                                       phone:  318-237-3019
                                       fax:  318-322-1997
                                       e-mail:  pastorsmith03@yahoo.com
                                       relationship to entity:  Director