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City Manager's Office - M-31
<br />Cit of Santa Ana 20 Civic Center Plaza
<br />Donation Request
<br />,,,. y N -2019 -018 -OS P.O. Box 1986
<br />Santa Ana, CA 92702
<br />"�"'�-" - (714) 647.5200
<br />Contact information
<br />Name: Ruby Gonzales -Woo tie: President
<br />ad..
<br />2234 N. Pacific Ave
<br />city, state, zip:
<br />I Santa Ana, CA 92706 Phone: 714-835-8925
<br />Emag:
<br />wooruby@yahoo.com
<br />Fax:
<br />none
<br />I Name: (Artesia Pilar Neighborhood Association (APNA)/Charitable Ventures of Orange County
<br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as elect One: ❑
<br />defined under Sectlon 501(c)(3) of the Internal Revenue Code? Yes No
<br />NNo, you will only qualify for a credit for Cily-related costs Por your request (i.e. permit fees, r.Y74.
<br />taff time, rental rates for facilities or equipment, etc.).Costs for City services vary and ff208756660
<br />approved, credit may or may not cover full cost of requested City services.
<br />Donation Request
<br />mi Services Credit
<br />Requested:
<br />Data Needed: Dec. 10, 2018 Ma orfCouncllmember: Please Choose From the List Below
<br />y
<br />ount
<br />Direct Payment Amount $500
<br />Event Date:
<br />Council Meeting Date:
<br />Event Time:
<br />12:00
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<br />equested:
<br />Approved Amount
<br />Dec. 15, 2018
<br />noon
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<br />Date:
<br />1-14-77 a t
<br />Event Location:
<br />Lydia Romero Cruz, 2701 W. 5th Street, Santa Ana, CA 92703
<br />Address, Oty, State, Zip
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<br />Description of
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<br />Event PUrpOee:
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<br />Community involvement of 300-600 youth and residents that works with them to build strong healthy
<br />Community Benefit:
<br />oommunities and help families thrive.
<br />Applicant Signature: _
<br />„alae -
<br />Date: _._
<br />November24 2018
<br />r -
<br />Return completed form Via:
<br />Mail: City Manager's Office -M-31 Email: donationrequest@santa-ana.org
<br />20 Civic Center Plaza Fax: (714) 617.6954
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
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<br />Donation Request#:
<br />Reference # on all related DPVs
<br />DR-
<br />Council Meeting Date:
<br />12/18/19
<br />Eligibility Met
<br />YES I NO YeS
<br />Approved Amount
<br />$500
<br />City Manager Signature:
<br />`ZS� _
<br />Date:
<br />1-14-77 a t
<br />Revised 11116=18
<br />
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