Kappa Youth Development, Inc.

2011 CFCNCA Application #1486

ATTACHMENT A - Statement of Real Services, Benefits, Assistance or

Program in 2010

The Kappa Youth Development, Inc. has provided community services in the District of
Columbia and Southern Maryland Counties. Our office is located at 1250 Connecticut Avenue,
NW, Suite 200, Washington, DC. The office hours are from 8:30 a.m. to 5:30 p.m., Monday
through Friday. Kappa Youth Development was chartered in Maryland in 1994 to provide
community services and received its IRS 501(c)3 exempt organization status in 1995 (EIN: 52-
1905339). Kappa Youth Development is a separate non-profit organization of the Upper
Marlboro/Waldorf (MD) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. ®.

Youth Initiatives Our youth initiatives seek to provide minority adolescent males a transition
into outstanding students of high moral character, effective leaders in their communities and
healthy adulthood; through focusing on limiting high risk and health behaviors. Specific
programs in the Metropolitan District of Columbia area include—Mentoring and Tutoring,
Building Self-Esteem, Leadership Training, and College Scholarships (available to all students).

Since 1995, Kappa Youth Development has engaged in mentoring, tutoring, and development of
over 500 youths, focusing on reading, math, and life skills. For example, throughout 2010
Kappa Youth Development has provided tutoring to about 50 children at an academically-
challenged elementary school. We also have provided mentoring to 10 college-bound students
and awarded 5 college scholarships in 2010.

With continued support from our friends and others, Kappa Youth Development expects to
increase its achievements regarding youth initiatives and scholarships in 2011 and future years.

Health Initiatives Kappa Youth Development Kappa Kare Initiative supports a health awareness
program that promotes the self conscience to the health care crises of Men-of-Color and their
families. Kappa Kare assist them in accessing health information that will educate and
encourage Men-of-Color to live long, healthy lives. Health-fairs, forums and workshops are
used to provide health information as well as health screenings and testing. Kappa Kare
Initiative targets the entire Metropolitan District of Columbia area. Key health risk factors are
obesity, violence, HIV/AIDS, heart disease, cancer, and mental health.

Through its Kappa Kare® program, KYD has provided health care awareness and education
promotions as well as HIV/AIDS testing and counseling at the following events sponsored by the
University of Maryland, School of Public Health, in College Park, MD during 2010:

• Riverdale Multicultural Center Community Health Fair, Riverdale, MD; 4/25/10

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2011 CFCNCA Application #1486

• Town of Seat Pleasant Community Health Fair, Seat Pleasant, MD; 5/1/10

ATTACHMENT A - Continued
• Beltsville Community Center Health Fair, Beltsville, MD; 11/15/10

Others

• Community Health Fair at National Harbor, Fort Washington, MD, sponsored by Prince
George’s County Health Department; 5/15/10

• Community Health Fair, sponsored by New Life Community Church, Bowie, MD;
5/22/10

• Community Health Fair, sponsored by Christ Community Church, Bowie, MD; 8/21/10

• Combined Federal Campaign Charity Fair, sponsored by US Department of Agriculture

National Agricultural Research Center, Beltsville, MD; 01/12/10

Kappa Youth Development provided health education and awareness material to about 1600
persons who visited our displays at the above health fairs. In addition, we have encouraged them
to get regular medical check ups and exercise, when possible.

NBC4 Health and Fitness Expo On January 16 -17, 2010, about 85,000 visitors attended the 2-
day NBC4 Health and Fitness Expo at the Walter Washington Convention Center in Washington,
D.C. About 1,000 visitors stopped by the Kappa Youth Development (KYD) Exhibit/Booth
where we discussed and provided handouts concerning our health awareness programs and youth
initiatives such as mentoring, scholarships and Call Dad program. Another 500-600 visitors
stopped and read our large Kappa Kare banner. We also gave away about 1,000 male and female
condoms, and our HIV/AIDS testing partner screened 75 persons at this 2-day event. (Kappa
Youth Development also participated in the NBC4 Health and Fitness Expo on January 15 and
16, 2011, which was our fifth year of participation in this event.)

National Library of Medicine/National Institutes of Health (NIL/NIH) The Year 2010 was our
fourth consecutive year of collaborating with NIL/NIH to provide materials and instructions to
persons who visited our health fairs, workshops and exhibits at NBC4 Health and Fitness Expo.
In 2010 we encouraged and/or instructed about 1200 visitors who attended our health awareness
events on how to access NLM’s consumer health information web sites, containing information
on over 800 topics on conditions, diseases and wellness, interactive health tutorials, drug
information, current health news, dictionaries, directories and other resources.

DC Department of Health Effi Barry HIV/AIDS Program Beginning in October 2010, Kappa
Youth Development started participating in the Effi Barry HIV/AIDS Program. Kappa Youth
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2011 CFCNCA Application #1486
Development is engaged in this training program which is designed to develop and expand
comprehensive services targeting communities most impacted by HIV/AIDS. For example, we
are preparing HIV/AIDS testing sites, and condom distribution sites at several communities

ATTACHMENT A - Continued

in the District of Columbia. A recent DC Department of Health epidemiology study showed that
certain segments of the District of Columbia have one of the highest HIV incidents in the United
States. Kappa Youth Development has four members who have been trained and certified to
conduct HIV/AIDS testing, counseling and make referrals. Kappa Youth Development is doing
its “call to action” to fight the HIV/AIDS epidemic while embracing the President’s National
Strategy on HIV/AIDS.

We anticipate that our 2011 HIV/AIDS prevention activities will impact on the lives of more
than 3,000 persons and have a greater impact exponentially on future generations of the citizens
in our communities.
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2011 CFCNCA Application #1486

ATTACHMENT B - IRS Determination Letter, including Employer Identification Number

Please accept a copy of our 2009 IRS Determination Letter while we wait for the receipt of a
more current Determination Letter which we have requested from the IRS. An IRS
representative informed us that IRS no longer fax Determination Letters—they are now sent by
mail. Also, enclosed is a copy of a page from IRS Publication 78 which shows that Kappa Youth
Development, Inc. is still listed as an eligible exempt organization as of January 26, 2011. In
addition, we have included a correspondence showing that IRS accepted Kappa Youth
Development’s 2009 Form 990-N (under $25,000) as of February 8, 2010.

Kappa Youth Development, Inc. EIN: 52-1905339

 Kappa Youth Development, Inc.
2011 CFCNCA Application #1486

ATTACHMENT C – Audited Annual Financial Statement for Organizations with $250,000 or

more.

N/A
 Kappa Youth Development, Inc.
2011 CFCNCA Application #1486

ATTACHMENT D – A Complete Signed Copy of A Pro Forma IRS Form 990

Enclosed is a signed copy of a Pro Forma IRS Form 990 for Tax Year Ending September 30,
2009.
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2011 CFCNCA Application #1486

ATTACHMENT E – A Twenty-five Word Statement and Optional Taxonomy Codes

Our twenty-five word statement for listing in the campaign brochure: “Provides college
scholarships, mentoring, leadership training and builds self-esteem to youths. Provides health
and wellness programs through community health fairs, forums, and workshops.”

Legal Name: Kappa Youth Development, Inc.

EIN: 52-1905339

Telephone No.: 703 408-2622

Administrative and Fundraising Rate: 8.5%

Internet Address: www.kappakare.org

Optional Taxonomy Codes: EOS