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City of Santa Ana <br />Donation Request <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 />IN - a I m a - : _11---l- [Victor de los Santos �Title._ Director of Bands <br />-- -- -------- <br />020 West Walnut Street <br />!city, State, Zip: Santa Ana, CA 9-2-7- 61 [Phone:- (714 -567 4990 <br />[Email: Ivictor. elossantos@sausd.us IF= 1714-567-4998 <br />1 1 i <br />..... . ......... _ <br />Name: Santa Ana High-school Marching Band Boosters <br />Tax-Exempt Status: is your organization a non-profit or public tax-exempt organization as On <br />Idefined under Section 501(c)(3) of the Internal Revenue Code? ISelect One: Yes ❑ No <br />1 <br />if No, you will only qualify for a credit for City-related costs for your request (i.e permit fees,I -- ---- — ------ <br />Istaff time, rental rates for facilities or equipment, etc.). Costs for City services v... and .. 95 6002823 <br />Approved, credit may or may not cover full cost of requested City services. Tax ID #: <br />City Services- -credit- E <br />Amount Requested: 1$ <br />,Direct Payment Amount $ <br />,Requested: <br />Event Location: <br />Address, City, State, Zip I [ <br />F <br />Description of <br />Event /Purpose: <br />IDate Needed: <br />1,000 1 1 <br />'Event Date; 1 12/14/16 <br />Mayor/Councilmember: [Amezcua <br />(Event - Time - . .. ... jr 7:-00 pm <br />Santa Ana High School <br />520 West Walnut Street, Santa Ana, CA, 92701 <br />Santa Ana High School's Winter Concert. The concert is to bring our community to <br />together for an evening full of music performed by the youth of Santa Ana High School. <br />I he community will berietit Trom seeing their own tamely members perform a high <br />.y Benefit: level of music. Instead of bring outside groups, this educate our community about <br />the high leve of music being offered in our public school system. <br />---- ------ — <br />Signature: Date- 19/13/16 <br />I Return completed form via: I <br />I F Mail: City Manager's Office - M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Email: donationrequest@santa-ana.org <br />Fax: (714) 647-6954 <br />j Donation Request #: DR - Council Meeting Date: <br />R'Veumce it oa all'ohated npvs <br />Eligibility Met: j YES i NO Approved Amount: <br />City Manager Signature: <br />EXHIBIT 1 Date: <br />29A-3 Revised 11/16/2015 <br />