Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BOYS & GIRLS CLUB OF GREATER LA CROSSE INC
Employer identification number
39-6084791
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
799,818
1,460,607
838,472
923,310
958,547
4,980,754
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
799,818
1,460,607
838,472
923,310
958,547
4,980,754
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
678,518
6
Public support. Subtract line 5 from line 4.
4,302,236
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
799,818
1,460,607
838,472
923,310
958,547
4,980,754
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
212,694
239,057
101,030
254,716
276,772
1,084,269
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
6,065,023
12
Gross receipts from related activities, etc. (see instructions)
..................
12
302,566
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
70.940 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
69.200 %
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BOYS & GIRLS CLUB OF GREATER LA CROSSE INC
Employer identification number
39-6084791
Identifier
Return Reference
Explanation
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
THE BOYS & GIRLS CLUBS OF GREATER LA CROSSE HAS A TOTAL OF SEVEN LOCATIONS IN THE LA CROSSE AREA, INCLUDING SITES IN LA CRESCENT, MINNESOTA, THE SCHUH-MULLEN LOW INCOME HOUSING DEVELOPMENT, THE HUBER HOMES LOW INCOME HOUSING DEVELOPMENT, AND HAMILTON ELEMENTARY SCHOOL. OUR SITES SERVE MEMBERS IN KINDERGARTEN THROUGH 12TH GRADE. AN ANNUAL CLUB MEMBERSHIP COSTS 20.00 AND GRANTS ACCESS TO ALL SEVEN OF OUR SITES AND THE PROGRAMMING PROVIDED AT THOSE SITES. OUR CLUBS ARE OPEN FOR AFTER SCHOOL PROGRAMMING DURING THE SCHOOL YEAR AND HAVE EXTENDED HOURS IN THE SUMMER. THE BOYS & GIRLS CLUBS OF GREATER LA CROSSE TAKE A PROACTIVE APPROACH TO HEALTHY YOUTH DEVELOPMENT THROUGH THE FACILITATION OF POSITIVE RELATIONSHIPS BETWEEN YOUNG PEOPLE, THEIR PEERS, AND ADULT LEADERS, AND SPECIALIZED PROGRAMMING. OUR CLUBS FOCUS ON YOUTH PROGRAMMING IN THREE CORE AREAS: ACADEMIC SUCCESS, CHARACTER AND LEADERSHIP DEVELOPMENT, AND HEALTHY LIFESTYLES. WITHIN THOSE CORE AREAS, OUR CLUBS CONDUCT BOYS & GIRLS CLUBS OF AMERICA NATIONAL PROGRAMS, AS WELL AS LOCALLY DEVELOPED PROGRAMS. SOME OF THE NATIONAL PROGRAMS WE RUN ARE SMART GIRLS, WIZE GUYZ, TRIPLE PLAY, AND POWER HOUR. SMART GIRLS AND WIZE GUYZ ARE GENDER SPECIFIC CHARACTER AND LEADERSHIP DEVELOPMENT PROGRAMS FOR MEMBERS IN 6TH - 12TH GRADE. THROUGH THESE PROGRAMS, MEMBERS EXPLORE THEIR OWN ATTITUDES AND SOCIETAL VALUES IN THE AREAS OF HEALTHY LIFE STYLES, SELF ESTEEM, DECISION MAKING, LIFE SKILLS, ALCOHOL/DRUG USE, GANGS, HEALTHY RELATIONSHIPS, CONFLICT RESOLUTION, DIVERSITY AND LEADERSHIP. TRIPLE PLAY IS A PROGRAM FOR ALL AGES AND IS FOCUSED ON THREE AREAS OF HEALTH AND WELLNESS: PHYSICAL FITNESS, HEALTHY EATING, AND SOCIAL RECREATION. IN THIS PROGRAM, MEMBERS PARTICIPATE IN GYM, GAMES ROOM, AND COOKING ACTIVITIES. POWER HOUR IS CLUB TIME DEDICATED TO ACADEMIC SUCCESS. DURING POWER HOUR, MEMBERS CAN RECEIVE HELP WITH THEIR HOMEWORK OR PARTICIPATE IN EDUCATIONAL ACTIVITIES AND GAMES WHICH EXTEND WHAT THEY ARE LEARNING IN SCHOOL. IN ADDITION TO THE BGCA NATIONAL PROGRAMS, OUR CLUBS RUN DAILY ACTIVITIES IN OUR MANY PROGRAM AREAS. MEMBERS ARE ABLE TO PARTICIPATE IN STRUCTURED ACTIVITIES AND FREE TIME IN THE ART ROOM, GAMES ROOM, COMPUTER LAB, TEEN CENTER, GYM, AND PLAYGROUND. WE HAVE ALSO DEVELOPED A NUMBER OF COMMUNITY PARTNERSHIPS WHICH ALLOW OUR MEMBERS TO EXPERIENCE A VARIETY OF LEARNING ACTIVITIES SUCH AS SWIMMING, MARTIAL ARTS, HIKING, SKIING, AND OTHER FIELD TRIPS. WHETHER IT IS A BOYS & GIRLS CLUBS OF AMERICA NATIONAL PROGRAM OR LOCAL PROGRAM, MEMBERS HAVE A LARGE SELECTION OF ACTIVITIES TO PARTICIPATE IN EVERY DAY AT THE CLUB. IN ADDITION TO OUR AFTER SCHOOL AND SUMMER PROGRAMS, OUR CLUBS HOST A LARGE SELECTION OF YOUTH DEVELOPMENTAL ATHLETIC PROGRAMS FOR YOUTH AGES 4 THROUGH 16, INCLUDING TACKLE FOOTBALL, FLAG FOOTBALL, BASKETBALL, WRESTLING, BASEBALL, SOFTBALL, AND TEE BALL. THROUGH OUR ATHLETIC PROGRAMS, MEMBERS WORK CLOSELY WITH QUALIFIED AND DEDICATED COACHES AND LEARN THE SKILLS NECESSARY FOR THE SPORT, THE IMPORTANCE OF TEAMWORK, AND GOOD SPORTSMANSHIP. MANY OF THE CLUB'S ATHLETIC PROGRAMS ARE RUN OUT OF THE ERICKSON CLUB, HOWEVER, THERE ARE SOME ATHLETIC ACTIVITIES OFFERED AT ADDITIONAL SITES, SUCH AS LA CRESCENT AND WEST SALEM. OVERALL, THE BOYS & GIRLS CLUBS OF GREATER LA CROSSE ANNUALLY SERVES NEARLY 4,000 AREA YOUTH THROUGH OUR AFTER SCHOOL AND ATHLETIC PROGRAMS. WE ARE ABLE TO CREATE POSITIVE RELATIONSHIPS WITH THESE YOUTH AND THROUGH OUR FUN AND INTERACTIVE PROGRAMMING, TEACH THEM VALUABLE LIFE SKILLS WITHIN OUR THREE CORE PROGRAM AREAS.
RELATED PARTY INFORMATION AMONG OFFICERS
FORM 990, PAGE 6, PART VI, LINE 2
DAN GELATT KENT HANDEL DIRECTOR DIRECTOR EMPLOYER/EMPLOYEE SCOTT MATHY MATT WATSON DIRECTOR DIRECTOR EMPLOYER/EMPLOYEE BOB ALLEN CHRIS HARKNESS PRESIDENT DIRECTOR MANAGER/ADVISOR
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE CLUB'S BOARD PRESIDENT AND TREASURER, AS WELL AS, THE CLUB'S EXECUTIVE DIRECTOR AND FINANCE MANAGER REVIEW THE FORM 990 PRIOR TO ITS FILING. THE FINAL FORM 990 IS DISTRIBUTED TO THE FULL BOARD.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE CLUB'S EXECUTIVE DIRECTOR AND BOARD COMMITTEE CHAIRS MONITOR AND ENFORCE COMPLIANCE.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
YES, THE CLUB FOLLOWS THE REBUTTABLE PRESUMPTION PROCEDURES WHEN DETERMINING THE EXECUTIVE DIRECTOR'S COMPENSSATION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
PRESENTLY, THE CLUB WILL PROVIDE ITS GOVERNING DOCUMENTS TO THE GENERAL PUBLIC UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
CHANGE IN PERPETUAL TRUSTS 210,720 SPECIAL EVENTS COSTS 52,290 CONTRIBUTIONS TO VITERBO -57,000 SPECIAL EVENTS COSTS -52,290
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.