2025 LA SCCC - Charity Application

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Thank you for your interest in the
Louisiana State Combined Charitable Campaign!
Since 2014, Louisiana charities have received more than $2 million in donations through this annual giving campaign fueled by the generosity of the employees of the State of Louisiana.

LA SCCC Application Review Team:
The Louisiana Association of United Ways (LAUW) serves as the Principal Combined Fundraising Organization (PCFO) for the LA SCCC. LAUW works closely with the Louisiana Office of State Uniform Payroll (OSUP) to review all applications for eligibility based on established guidelines. The final roster of LA SCCC admitted charities is approved by the Louisiana Division of Administration, Commissioner of Administration.

The following organizations are invited to apply to be a part of the LA SCCC:
Health and human service non-profit organizations registered through the Louisiana Secretary of State, meeting all requirements set forth in LA R.S. 42:456(A)(3) and the Louisiana Administrative Code Title 4, Part III, Chapter 11.

Here are the application options, with delivery instructions for both:

The deadline to submit your application is Thursday, February 27, 2025.

Option 1: Apply online using this online form by the end of the day on Thursday, February 27, 2025. You will be asked to upload all required documents as part of the online process. Application fee accepted by credit card only.

Option 2: To submit a paper application found online at www.lasccc.org/application, the original of the application with all requested documents and one complete photocopy must be received by the Office of State Uniform Payroll no later than 4:30 p.m. on Thursday, February 27, 2025. Do not place in binders or staple/bind. Enclose application fee in packet in the form of payment made by check or money order (payable to LAUW). Please follow the mailing/delivery instructions found on the cover of the paper application.

Notification of Outcome of Application Review:
Your organization will be notified by the Louisiana Division of Administration no later than June 30, 2025. Notification letters will be directed to the Chief Executive Officer (CEO), using the CEO mailing address provided in this application.

How to Save your Online Application:

To successfully complete this form, please DO NOT create a JotForm Account or log into JotForm.

Use the SAVE option at the bottom of the screen.

Select "Skip Create an Account", which will allow you to view and share your saved application (for approval purposes) before submission.

Enter your e-mail address and send your Application Draft Link to your e-mail for future access.

Please save this e-mail and link once received.

To have your leadership review and sign this application, please e-mail your CEO the Application Draft Link and ask them to review, certify and approve the application (with signature). Once their review and actions are complete, they also must SAVE their changes.

Important notes about using our Online Application:

If you log into JotForm while completing and saving this form, it will not allow you to share your Application Draft Link with your charity's CEO for approval. You will only be able to access the application form using your JotForm login credentials. Please only share this form with your charity's CEO.

Drafts not submitted within 2 months will be automatically deleted by JotForm.

Please consider using Chrome or Firefox when completing this online form.

For tips on applying online, please click here.

Attachment files should be reviewed and approved by your leadership (CEO) prior to submission. Your charity's CEO will not be able to access any uploaded files due to recent platform changes by JotForm. Upon the submission of this application, your Application Staff Contact and CEO will receive an e-mailed copy of your charity's application with links to all files uploaded.

Documentation and all contents must correspond to the applicant’s legal name and Federal Tax Identification Number (EIN).

Thank you! We look forward to receiving
your application by Thursday, February 27, 2025.

_____________________________________________________________________

For questions or assistance, e-mail us at sccc@launitedway.org or call (225) 295-6631.

Louisiana Association of United Ways proudly serves as the Principal Combined Fundraising Organization for the Louisiana State Combined Charitable Campaign.
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To submit your Online Application, you MUST follow these instructions when saving your form:

To successfully complete this form, please DO NOT create a JotForm Account or log into JotForm.

Use the SAVE option at the bottom of the screen.

Select "Skip Create an Account", which will allow you to view and share your saved application (for approval purposes) before submission.

Enter your e-mail address and send your Application Draft Link to your e-mail for future access.

Please save this e-mail and link once received.

For Certifications & Approval by Authorized Agents, please e-mail your CEO the Application Draft Link and ask them to review, certify and approve the application (with signature). Once their review and actions are complete, they also must SAVE their changes.

NOTES:
If you log into JotForm while completing and saving this form, it will not allow you to share your Application Draft Link with your charity's CEO for approval. You will only be able to access the application form using your JotForm login credentials. Please only share this form with your charity's CEO.

Drafts not submitted within 2 months will be automatically deleted by JotForm.
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Important Notes:

Attachment files should be reviewed and approved by your leadership (CEO) prior to submission. Your charity's CEO will not be able to access any uploaded files due to recent platform changes by JotForm.

Upon the submission of this application, your Application Staff Contact and CEO will receive an e-mailed copy of your charity's application with links to all files uploaded.
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Organization's Legal name:* This field is required. (as currently registered with the Louisiana Secretary of State)
Charitable Organization's Legal Name (as currently registered with the Louisiana Secretary of State)
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Individual completing this application:* This field is required.(This person serves as the staff contact to the LA SCCC team to address needs or questions for this application.) Upon the submission of this application, your Application Staff Contact and CEO will receive an e-mailed copy of your charity's application with links to all files uploaded.
Full Name
Telephone Number
E-mail Address
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Additional Staff Contact #1:* This field is required.You may list up to three staff members to receive LA SCCC correspondence related to activities, trainings, and opportunities to serve as a charity presenter.
Full Name
Telephone Number
E-mail Address
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Additional Staff Contact #2 (optional):You may list up to three staff members to receive LA SCCC correspondence related to activities, trainings, and opportunities to serve as a charity presenter.
Full Name
Telephone Number
E-mail Address
8
Additional Staff Contact #3 (optional):You may list up to three staff members to receive LA SCCC correspondence related to activities, trainings, and opportunities to serve as a charity presenter.
Full Name
Telephone Number
E-mail Address
9
Information needed for Donation Handling - Mailing Address:* This field is required.Provide your organization’s mailing address to be used for all donation payments: NOTE: If your organizational mailing address changes from the time of this submission, please notify us at sccc@launitedway.org.
Street Address or P.O. Box
Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Information needed for Donation Handling - Staff Contact:* This field is required.Indicate your staff contact authorized for matters related to LA SCCC donations and annual donor list:
Full Name
Telephone Number
E-mail Address
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Federal Tax Identification Number (EIN) for your organization:* This field is required.- Your 990’s organizational EIN must correspond with the number provided below. - If your charity is a subordinate organization covered in a group tax exemption, list the EIN # for both your subordinate organization and central/parent organization.
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Is your charity a subordinate organization covered in a group tax exemption with the IRS?
YESNO
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Fundraising and Administrative Expenses (FRA) Calculation Data:* This field is required.The FRA is the total support and revenue (restricted and unrestricted) that an organization allocates to fundraising and administrative expenses. ****** To be eligible to participate in the LA SCCC, your FRA must not exceed 25%. ****** Complete the calculation using your most recent 990 submitted for this application. Important note: Your 990 must correspond with the legal name and EIN provided in this application.
Mgmt. & Gen. + Fundraising Expenses = “Functional Expenses” on Page 10 of Form 990 (Line 25, Columns C + D)
Total Revenue = “Total Revenue” on Page 9 of Form 990 (Line 12, Column A)
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Fundraising and Administrative Expenses (FRA) Calculation:* This field is required.(Mgmt. & Gen. + Fundraising Expenses) / (Total Revenue) = FRA (which must not exceed 25%)
****** To be eligible toparticipate in the LA SCCC, your FRA must not exceed 25%. ******
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What was the estimated dollar value of services provided to the citizens of Louisiana by your organization between January 1, 2024 and December 31, 2024?* This field is required.
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What health and human services does your charity provide in Louisiana?* This field is required.
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Large
Normal
Small
Ok
Ok
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Attachment A* This field is required.Most recent IRS Form 990 filed with the IRS. - A 990 EZ cannot be used. - If you are a charity applying under your national or central/parent organization and using its EIN, submit the national or central/parent organization 990 filed. State Pro formas, not filed with the IRS, will not be accepted. - If your organization is not required by the IRS to file a Form 990, submit a pro forma IRS 990 and complete pages 1, 2, 9, and 10.
Drag and drop files here
Select files to upload
Max. file size: 29.3MB
Most recent IRS Form 990 filed with the IRS.
Cancelof
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Attachment B* This field is required.Proof of IRS 501(c)(3) Status with matching legal name and EIN If your charity is a subordinate organization covered in a group exemption, provide documentation for both your subordinate organization and central/parent organization.
Drag and drop files here
Select files to upload
Max. file size: 3.0MB
Proof of IRS 501(c)(3) Status with matching legal name and EIN
Cancelof
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Attachment C* This field is required.Most recent CPA Audit, Compilation or Sworn Financial Statement - To fulfill this requirement, submit your most recent audited financial statement performed by a CPA within the last 12 months (from submission date). Your statement must meet Louisiana Legislative Auditor requirements and correspond with your annual fiscal year. - If your organization is not required by the Louisiana Legislative Auditor’s office to submit an audited financial statement, provide a sworn financial statement or compilation report.
Report is for fiscal year ending:
Date of Report:
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Attachment C* This field is required.Most recent CPA Audit, Compilation or Sworn Financial Statement
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Max. file size: 13.0MB
Most recent CPA Audit, Compilation or Sworn Financial Statement
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Attachment D* This field is required.Annual Budget for the Current Fiscal Year (12-month period required)
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Max. file size: 3.0MB
Annual Budget for the Current Fiscal Year (12-month period required)
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Attachment E* This field is required.Registration with the LA Secretary of State or proof of Congressional Charter - Provide a copy of your certificate issued by the LA Secretary of State. This certificate must correspond with your Legal Name provided in Part A. - If you do not have a certificate issued by the LA Secretary of State, provide a copy of the page displaying your organization’s name as listed in the database on the LA Secretary of State’s website: https://coraweb.sos.la.gov/CommercialSearch/CommercialSearch.aspx. - If you hold a Congressional Charter, submit a copy of your charter.
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Select files to upload
Max. file size: 3.0MB
Registration with the LA Secretary of State or proof of Congressional Charter
Cancelof
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Attachment F* This field is required.List of Board Members and Board Officers (current at time of submission)
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Select files to upload
Max. file size: 3.0MB
List of Board Members and Board Officers (current at time of submission)
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Charity Listing Information - Charity List Name:When published in the LA SCCC Charity List, your organization’s name, website address, organizational phone number, regions served, and listing statement will be depicted. Please provide your charity's name to be listed in the 2025 LA SCCC Charity List. - Please list your charity name as currently registered with the Louisiana Secretary of State. - If using a Trade Name, your trade name registration with the LA Secretary of State Office must be included in your application submittal.
Charity List Name (Charity's name OR trade name as currently registered with the Louisiana Secretary of State).
25
Is your charity using a Trade Name for the Charity Listing?
YESNO
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Trade Name RegistrationIf your organization request a trade name be used for the 2025 LA SCCC Charity List, provide your trade name registration issued by the Louisiana Secretary of State with this application. All trade names used in the LA SCCC must be registered with the Louisiana Secretary of State.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Trade Name Registration as provided by the Louisiana Secretary of State.
Cancelof
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Charity Listing Information - Website Address & Organizational Telephone #:* This field is required. When published in the LA SCCC Charity List, your organization’s name, website address, organizational phone number, regions served, and listing statement will be depicted. Please provide your charity's website address and organizational telephone number to be listed in the 2025 LA SCCC Charity List.
Charity Website Address
Organizational Telephone Number
28
Charity Listing Information - Charity Listing Statement:* This field is required. When published in the LA SCCC Charity List, your organization’s name, website address, organizational phone number, regions served, and listing statement below will be depicted. Please provide your charity's listing statement to be listed in the 2025 LA SCCC Charity List. This listing statement below must not exceed 25 words. Use complete sentences and do not write in first person. If you exceed 25 words, discretionary edits will be made to reduce words. To view last year’s statements, visit https://www.lasccc.org/charity-list.
0/25
Huge
Large
Normal
Small
Ok
Ok
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Charity Listing Information - Regions served by your charity:When published in the LA SCCC Charity List, your organization’s name, website address, organizational phone number, regions served, and listing statement below will be depicted. Review the map below and on the next page indicate which region or regions is served by your organization. Charities may provide services to one or more parish per region.
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Please indicate which Region or Regions is served by your charitable organization:* This field is required.When published in the LA SCCC Charity List, your organization’s name, website address, organizational phone number, regions served, and listing statement below will be depicted. Charities may provide services to one or more parish per region. (See previous page for map of regions)
1
6
2
7
3
8
4
9
5
ALL REGIONS
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Additional marketing information for LASCCC.org - Charity's Organizational Logo* This field is required.A digital copy of your charity's organizational logo (JPG or PNG format).
Drag and drop files here
Select files to upload
Max. file size: 1.0MB
Charity's organizational logo
Cancelof
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Certifications by Authorized Agent:

For this section, please ask your Charity's CEO/ExecutiveDirector to review the entire application and its content and certify and sign this application.

To successully complete this form, please DO NOT create a JotForm Account or Log into JotForm.

Simply select the SAVE option at the bottom of the screen.

Select "Skip Create an Account", which will allow you to view and share your saved application (for approval purposes) before submission.

Enter your e-mail address and send your Application Draft Link to your e-mail for future access.

Please save this e-mail and link once received.

E-mail your Charity's CEO/Executive Director the Application Draft Link and ask them to review, certify and approve the application (with signature). Once their review and actions are complete they also must SAVE their changes.

Once all approvals are received, please COMPLETE your application by paying the Application Fee and proceed with reviewing and submitting your application.

NOTE: If you log into JotForm while completing and saving this form, it will not allow you to share your Application Draft Link with your charity's CEO for approval. You will only be able to access the application form using your JotForm login credentials. Please only share this form with your charity's CEO.
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Certifications by Authorized Agent:* This field is required.The Louisiana State Combined Charitable Campaign requires that all organizations applying for admission certify compliance with the requirements as outlined in this Campaign Application, as well as, LA R.S. 42:456(A)(3) and the Louisiana Administrative Code Title 4, Part III, Chapter 11. To certify, an Authorized Agent for your organization must review each compliance measure, check to certify compliance, and sign this application once complete. This agent’s signature indicates accuracy and approval for the entire application package. (to sign, see next section)
This organization is requesting inclusion into the 2025 LA SCCC and is in compliance with LA R.S. 42:456(A)(3) and the Louisiana Administrative Code Title 4, Part III, Chapter 11.
This organization is providing our most recently filed IRS 990 form for the purposes of calculating our fundraising and administrative expenses to confirm eligibility. (If your organization is not required to file an IRS 990 form a pro forma 990 shall be submitted for the same purposes.)
This organization is a volunteer, not-for-profit organization under section 501(c)(3) of the Internal Revenue Code, which provides health or human services to individuals and is not organized for cultural, educational, religious or political purposes as defined in §1109 of the Rule.
This organization will ensure that an equivalent amount collected as contributions through the LA SCCC will be spent to provide services and benefits primarily to the citizens of Louisiana unless an exception is granted per §1109.D of the Rule.
This organization will not use funds received from the LA SCCC for fundraising or administrative purposes.
This organization is in compliance with the USA Patriot Act of 2001.
This organization has no outstanding debt owed to any Agency of the State of Louisiana.
This organization operates without discrimination in regard to all persons and complies with all requirements of law and regulations respecting non-discrimination and equal employment opportunities with respect to its officers, staff, employees and volunteers.
This organization is in compliance with and is not listed on the Louisiana Legislative Auditors (LLA) non-compliance list.
This organization has a substantial local presence within Louisiana, defined as operations of at least 20 hours per week in Louisiana.
This organization is registered as an active, non-profit in good standing with the Louisiana Secretary of State Office or holds a congressional charter.
This organization currently is not under investigation for any reason.
This organization is governed by a board of directors which meets regularly and whose members serve without compensation.
This organization understands that solicitation of charitable donations through payroll deduction is only allowed during the LA SCCC annual campaign period.
This organization understands that LA SCCC campaign materials are produced and distributed by the Louisiana Association of United Ways (PCFO). Furthermore, we understand that LAUW collects information in Part C for these materials as part of this application process.
This organization understands that the Division of Administration shall have the power to accept or reject the certifications made within this application.
This organization understands that it shall be ineligible to receive donations from the 2025 LA SCCC if our organization ceases to operate. Additionally, if this organization merges with another entity, we are to notify the PCFO (LAUW). A merger event may alter participation in the 2025 LA SCCC, unless an exemption is requested and approved.
This organization understands that OSUP, in coordination with the Division of Administration’s Commissioner’s Office, may remove a charitable organization from the LA SCCC for violating the provisions of the Rule, other applicable provisions of law, or any directive or instruction from OSUP.
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Chief Executive Officer (CEO), Chief Professional Officer (CPO) or Executive Director (ED) (Approving Application):* This field is required.(This information will be used to communicate application approval and final campaign results.) Upon the submission of this application, your Application Staff Contact and CEO will receive an e-mailed copy of your charity's application with links to all files uploaded.
Full Name
Mailing Address (Street, City, State, Zip) - used to communicate application approval and final campaign results.
Title
Telephone Number
E-mail Address
Date of Signature of Approval
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CEO/CPO/ED Signature of Approval:* This field is required.By my signature below, I certify that this charitable application is accurate and complete within ALL Parts and is in compliance with the requirements as outlined in this Campaign Application, as well as, LA R.S. 42:456(A)(3) and the Louisiana Administrative Code Title 4, Part III, Chapter 11.
Clear
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Application Fee* This field is required.The charity application fee for the 2025 LA SCCC is $250 (fee is required and is non-refundable). Please complete this section once application is ready to be submitted and when your charity CEO has reviewed all information, certified application, and signed the application.
prevnext( X )
2025 LA SCCC application fee ($250)
USD
+ OR enter a custom value
First Name
Last Name
37
Billing Address* This field is required.
Organizational Name
Street Address
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Billing E-mail Address* This field is required.Please provide an e-mail address for payment receipt inquiries.
example@example.com
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Thank you for applying to be a part of the 2025 Louisiana State Combined Charitable Campaign (LA SCCC).

As part of the review process, information may be requested (via e-mail) to certify eligibility. Failure to furnish information within 10 days of request constitutes grounds for the denial of eligibility. The burden of demonstrating eligibility shall rest with the applicant.

Upon the submission of this application, your Application Staff Contact and CEO will receive an e-mailed copy of your charity's application with links to all files uploaded.

Notification of Outcome of Application Review:

Your organization will be notified by the Louisiana Division of Administration no later than June 30, 2025. Notification letters will be directed to the Chief Executive Officer (CEO), using the CEO mailing address provided in this application.

If you have any questions, please feel free to call 225-295-6631 or e-mail sccc@launitedway.org.

Louisiana Association of United Ways proudly serves as the Principal Combined Fundraising Organization for the Louisiana State Combined Charitable Campaign.
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