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Ci%t of Santa Ana N- City Manager's Ofce-M-39
<br />(5)
<br />Donation Request zo1y 01g 03 20clvl�n BoPlaza986
<br />Santa Ana, CA 92702
<br />(714) 647.5200
<br />Name:
<br />Ruby Gonzales -Woo
<br />tie: President
<br />adress:
<br />2234 N. Pacific Ave
<br />Event Location:
<br />Fit,, state, zip:
<br />I Santa Ana, CA 92706 Phone: 714-835-8925
<br />Emall:
<br />wooruby@yahoo.com
<br />Pax:
<br />none
<br />Name: Artesia Pilar Neighborhood Association (APNA)/Charitable Ventures of Orange County
<br />Status: Is your organization a non-pmtit or
<br />Section 501(c)(3) of the Internal Revenue I
<br />as
<br />will only qualify for a credit for Cityvelated costs for your request (i.e. permit fees,
<br />rental rates for facilities or equipment, etc.).Costs for Co services veryand if
<br />credit mayor may not eoverfull cost of requested City services.
<br />Donation Request
<br />elect One: Yes ❑ No
<br />Yaa' 208756660
<br />Tax ID #:
<br />tY
<br />C( Services Credit Date Needed: Dec. 10, 2018 Ma ar/Councilmember- Please Choose From the Ust Below
<br />mount Requested:
<br />Direct Payment Amount $250 Event Date. Event Tlme: Solorio
<br />Requested: Dec. 15, 2018 12.00 noon
<br />Donation Request P
<br />Reference # on all related DPVs
<br />Event Location:
<br />Lydia Romero Cruz, 2701 W. 5th Street, Santa Ana, CA 92703
<br />Address, qty, State, Tip
<br />Eligibility Met
<br />YES / NO YeS
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<br />don of
<br />Description
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<br />Event/Purpose:
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<br />Date:
<br />�u�i�w�v..�: w�.,oa.w%.°m�m.° xw�`.amx"somm
<br />Community involvement 300-800 youth and residents that works with them to build strong healthy
<br />Community Benefit
<br />communities and help families thrive.
<br />ApplicantSignature:�
<br />Data: _._
<br />November K,2018.
<br />a
<br />Return completed form via:
<br />Mail: City Manager's Office -M-31 Email: donationrequmt@santaana.org
<br />20 Civic Center Plaza Fax: (714) 647.8964
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
<br />Revised 11/16/2016
<br />Donation Request P
<br />Reference # on all related DPVs
<br />DR-
<br />Council Meeting Date:
<br />12/18/1.9
<br />Eligibility Met
<br />YES / NO YeS
<br />Approved Amount:
<br />$250
<br />City Manager Signature:
<br />_
<br />Date:
<br />I. IS, 7 t
<br />Revised 11/16/2016
<br />
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