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City of Santa Ana <br />Donation Request <br />(Name: Mequivi De La Rosa <br />'(,Address: 12618 West Alton Ave #B <br />Iclty, state, zip: !Santa Ana, CA 92704 <br />jEmall: Ixtreme96@sbcglobal.net <br />sbcglobal.net <br />Name: Santa Ana Xtreme Softball <br />City Manager's Office — M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647-5200 <br />Phone: 714-251.4518 <br />(Fax: <br />I Tax-Exem t Status: is .._.._ ..- _. <br />p Is -your ur organization anon -profit or public tax-exempt organization as Select One: I <br />defined under Section 501(c)(3) of the Internal Revenue Code? Yes ®No <br />(If No, you will only qualify fore credit for Chly relatad costs for your request (i.e. permit fees, pf Yes, <br />staff time, rental rates for facilities or equipment, eta,). Costs for City services very and If p n _®o G (� ®/� <br />(approved, credit may or may not cover full cost of requested City services. (Tax ID it: 18 L J 97 V <br />(City Services Credit <br />(Amount Requested: <br />I$ Date Needed 14/15116 MayarlCouncilmember:ITinajerc <br />Olrect Payment Amount <br />lRequestetl: <br />Requ <br />- Event pm <br />l$2500 (Event Date. 15/1 & 5122 Et Time. 18:00am - 5:00 <br />;Event Location:Carl <br />Thornton Park - 1801 West Segerstrom Ave, Santa Ana, CA 92704 <br />lAddmss, City, State, Zip <br />'Host softball scrimmage games with Santa Ana Xtreme Softball teams vs other <br />etlI tion of <br />(teams from the surrounding cities in Southern CA <br />EventlPur <br />Event Purpose: <br />- <br />(Keeping young female teenagers Involved Ina positive and constructive environment through playing softball, with an <br />iuitimate goal of having these players continue thier softball carsers into college with the potential of having these players <br />Community Benefit: <br />(receive athletic and academic scholarships to help offset the expenses of college. <br />Applicant Signature: <br />L41 <br />va w Al^'Oer. A&M - Date: 1,4h <br />A <br />Mall: City Manager's Ofloe—M-31 <br />20 Civic Center Plaza <br />P.O. Box 1968 <br />Santa Ana, CA 92702 <br />Email: donationrequest@santa-ana.org <br />Fax: (714) 647-6954 <br />Donation Request # DR <br />Rwmr .r MtrNnr 0.1 Council Meeting Date. <br />Eligibility Mat: YES i NO Approved Amount: <br />City Manager Signature: <br />Date: <br />Revised 11/16/2015 <br />