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r '" City Manager's Office -M-31 <br />.R'u,+ City of Santa Ana 20 Civic Center Plaza <br />Donation Request P.O. Box 9988 <br />Santa Ana, CA 92702 <br />'.yY - (714) 647-5200 <br />Ity, state, zip: Costa Mesa hens: 714-609-6607 <br />Name: (Orange County Grappling Fiscal Sponsor will be Santa Ana Athletic Foundation <br />.empt Status: Is your organization a non-profit or <br />under Section 501(c)(3) of the Internal Revenue i <br />as sleet One: Fv-] <br />Yes ❑ No <br />will only qualify for a credit for City -related costs for yourrequest Q.e. permit lees, If Yes, <br />rental rates for facilities or equipment, etc.).Costs for City services vary end it 91-2163665 <br />credit may or may not cover lull cost of requested City services. fax ID M <br />� Return Cornpleted form viaiPo. <br />Mail: City Manager's Office -M-31 I Email: donationrequest@santa-ana.org j <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />y1.i.�li��%..,,y44."iYd,is,.tlT�*�.G^,iiY"q-t'!q <br />r <br />tty Services Credit I` <br />Date Needed: F12/1/201 H ayor/Councllmember. I Martinez <br />ount Requested: �' <br />PIrect Payment Amount <br />—� <br />� 000.0 Event Date: Mons & Weds vent Time: 6PM <br />quested <br />YES 1 NO Yes - - <br />Santa Ana High School/ Wrasuing Ramon ' <br />Event Location: <br />sm W. waewl at <br />Address, City, State, Zip <br />Santa Ana, CA 92701 <br />I —� <br />ry Monday and Wednesday at 6pm we provide free wrestling instruction and tutoring for kids <br />Description of <br />des K -12th. The funds will be used for entry fees to compete in wrestling tournaments, as <br />Fw <br />Event / Purpose: <br />aS gear and food for the wrestlers/participants. <br />Orange County Grappling Club specifically exists to give hope and purpose to adolescent boys and gids in Santa Ana. <br />Community Benefit: <br />The benefit to the community is to empower and enable these adolescents to reach their highest potential and to achieve <br />their goals In lite. Thus, making positive conMbutions back to the city. We also exist to redirect negative behaviors toward <br />positive aviors, "teaching teens to wrestle through their aggressions and the pain that daily life may bring' <br />a <br />�_ v K �-t-� <br />v <br />•n-,�x�' < �a ,r..�c�'fv.�.. �+ s�i, <br />Rate kms. <br />I' <br />rF� <br />.. <br />� Return Cornpleted form viaiPo. <br />Mail: City Manager's Office -M-31 I Email: donationrequest@santa-ana.org j <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />y1.i.�li��%..,,y44."iYd,is,.tlT�*�.G^,iiY"q-t'!q <br />r <br />Donation Request H: <br />Ralerance 0 on all related DPlrs <br />DR - <br />Council Meeting Date: <br />12/4/1$ f <br />Eligibility Mot: <br />YES 1 NO Yes - - <br />Approved Amount: - <br />$1,000 <br />City Manager Signature: <br />Data: <br />I —� <br />Revised 01/05/2017 <br />