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�. City Manager's Office — M -3f 3 City of Santa Ana 20 Civic Center Plaza �) Donation Request P.O. Box 1988 Santa Ana, CA 92702 -- (714) 647-5200 Contact Information IName: Ramiro Barbuzano, Jr. ITiur e: Director of Education Pddresr- s. - 1815 E. Wilshire Avenue #906 city, state, zip: I Santa Ana, CA, 92705 Phenr e: 714-352-4380 Email: rbarbuzano@childcreativitylab.orgFar x: Organization Name: IChild Creativity Lab Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as I Select One defined under Section 501(cx3) of the Internal Revenue Code? Z Yes ❑ No If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, f -�f Yes, taN time, rental rates for facilities or equipment,etc.).Costs for City services very and if ,approved, credit may or may not cover full cost of requested City services. : [Tax ID #: 36-4746228 Donation (City Services Credit Date�Needed: /Amount Requested; m I 11/8/18 MayorlCoul ndlmember: I Martinez (Direct PaymentAmount S 1 Event Da et 12/8/18 Event Time: 10:00 am Requested; l Event t.ocation: TBD, but possibly at 1815 E. Wilshire Avenue #906, Santa Ana, CA 92705 if venue not secured. Addiress, City, State, Zip Tis Gve Wpesviry LODb maienbb lab, Ne nee penvNtn mlpltlwl Pimm, maametbev, Inmvalmn, eN batlm OwrohheMrm vet0rfyarl,amro apm]art T]s Description Or agsY�me<°nl<mlmpn[lumw,mA<Mro<asl,mmbtle„ea WE,aeOy �rtl,q Nelr pomMal mr pu<mYEevekpv�l.N mNtll+uEammwdeh. EVentl Purpose: Tna wend b meats b a.". in. IsnmNdp�e nCCLmf Pe GIISa Monroe, !,(G$0G) bf ellmu mh,rafts K. 0(1)"a-Gefena7 mpemup beGlh Erpw.emnnl ST Gnlaarca.Tme¢wler.nwrO belle Pewmawwe sanuro In..ISo.., Tednns,y, Enpnwfro.M.e,d Mnm ...Pb Melo enpaprgyeup cornea m ease Ot,m Pxn Ona<p.m. pWtos The Gin Seoul Empowerment STEAM conference allows young women the opportunity to use problem solving skills and come up with new and useful solutions solutions to modem day issues. Their entrepreneur projects will take Nem threugh a'design-thinking' methodology where gid scouts team the COmmafllty Benefit. of planning, designing, turning, and presenting their work to a disgnguished panel of judges from the community. Along with Ne increased spark in curiosity and the sense of accemplishmenl. the guts mil have the opportunity to showcase their completed pmleds to the rest of the cemmunityl APPllcant Signature: fid. 8A.rbcvz K,0', jr. ata: 18/6/2018 Return completed form via: Mail: City Managers Office—M-31 Email: donationrequest@santa-ana.org 20 Civic Center Plaza Fax: (714) 647-6954 P.O. Box 1988 Santa Ana, CA 92702 ____— _A`. Donation Request#: DR- _r_---------____ Refaen<e a on ,It related DPVs Council Meeting Date: September 4, 2018 Eligibility Met: YES I NO YES 1 Approved Amount: 51,000 City Manager Signature: _ Date: i — Revised 01105/2017 29A 6