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Clt of Santa Ana City Manager's Office —M -31 <br />y 20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />_ Santa Ana, CA 92702 <br />.m,,.. (714) 847.5200 <br />Contact Information <br />Name: Jose Rea tde: Program Director <br />ddress: 1201 S. Halladay St. _ <br />iry, state, zip: Santa Ana, CA 92707 Phone: 714- 357 -6697 <br />or .. <br />City Services Credit ate Needed: a /COUncilmember. Sanniento <br />�r1Coun_ <br />Name: Madison Park Neighborhood Association - GREEN Project <br />Tax - Exempt Status: Is your organization a non -profit or public tax - exempt organization w <br />efined under Section 501(c)(3) ofthe Intemal Revenue Code? <br />If No, you will only qualify fora credit for City- related costs for your request (i.e. permit fees, <br />taff ti me, rentalrates forfacliftles or equipment,etc.).Costs for Cityservices varyandif <br />pproved, credit may or may not cover full cost of requested City services. <br />elect Ona: <br />Yes No <br />r.yx�ea #: 180-0201690 <br />Mall: City Manager's Office —M -31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />_ Santa Ana, CA 92702 <br />Email: donationrequest @santaana.org <br />Fax: (714) 647-6954 <br />Revised 11/18/2015 <br />City Services Credit ate Needed: a /COUncilmember. Sanniento <br />�r1Coun_ <br />oust Requested: or <br />I <br />Direct Pa ant Amount <br />equestea <br />1,500 <br />Event Date: <br />05(21/2016 <br />Evem Time: <br />9:00 am to 1:00 PM I <br />Event. Location: <br />James Madison Elementary School -1124 E. Hobart St., Santa Ana, CA 92707 <br />Address, City, State, Zip <br />Health Education and Prevention programs will be offered free of charge to the surrounding <br />Description Purpose: of <br />Event /Purpose: <br />community to promote health and health behaviors among Santa Ana residents, youth and <br />9 y <br />adults. <br />Residents will receive training and information in CPR, child care seats, safety, legal <br />Community Bement: <br />advise, free books, free child boosters,bicycle helmets, food and vegetables at no cost. <br />W mlil <br />„.,. <br />0 0 WWI E� <br />Mall: City Manager's Office —M -31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />_ Santa Ana, CA 92702 <br />Email: donationrequest @santaana.org <br />Fax: (714) 647-6954 <br />Revised 11/18/2015 <br />