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rte"° City Manager's Office - M-31 <br />• City of Santa Ana 20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />- (714) 647-5200 <br />Contact Information <br />wame: Kevin Cabrera rue: Exec. Director <br />adreae: <br />3101 W Harvard St <br />Iclty, s� <br />Santa Ana, Ca. 92704 Phone: 714-733-0709 <br />EI <br />kcabrera@heritagemuseumoc.org <br />FFx. <br />Organization Information <br />Name: lHeritage Museum of Orange County <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as <br />defined under Section 501(c)(3) of the Internal Revenue Code? <br />elect One: <br />Yos <br />❑ <br />No <br />If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, <br />stafftime,rental rates for facilities ovequipment, Costs for City services vary and it <br />Y <br />�axelg5-3665050 <br />stofre)quest <br />approved, credit may or may not cover full cost of requested City services. <br />#: <br />,City Servi° �— Dorsi Needed: October 1 �Mayorlcou� nonmember: <br />S-01 --- - <br />ount Requested: i <br />d Payment LJOO FventDa stet October 26 me: 3 pm - 9 pm <br />Requesterect <br />iEventTi� <br />Event Location: <br />Heritage Museum of OC <br />Address, City, State, Zip <br />3101 W Harvard St, Santa Ana, CA. 92704 <br />ugar skull class showing youth how to make and decorate sugar skulls as part <br />Description of <br />[of <br />Event/ Purpose: <br />Dia de Los Muertos, and Ghosts of OC Trick or Treat on the museum property. <br />These event will be free to the community and we will be inviting SAUSD schools <br />Community Benefit: <br />to participate. <br />Applicant Signature: <br />Date: <br />completed <br />Mail: City Manager's Office- M-31Emall: <br />donationrequest@santa-ana.org <br />20 Civic Center Plaza <br />Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #: <br />DR - <br />Council Meeting Date: <br />Rererence_ on all rolated OPVs <br />Eligibility Met: YES I NO Approved Amount: 1 <br />City Manager Signature: _ _ I I Date: J <br />L <br />Revised 01105/2017 <br />AI7 <br />