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•City of Santa AnaDonationRequest <br />Jose J. Rea <br />Address: 616E Occidental <br />City Manager's Office - M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647-9200 <br />Executive Director (volunteer) <br />714-367-6697 <br />-- _-_ _—_— _._. __._- <br />l Tax -Exempt Status: Is your organization anon -profit or public tax-exempt organization as !Select One <br />,defined under Section 501(c)(3) of the Internal Revenue Code? Yes No <br />If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, - --------------' -'-" <br />!staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if Iif Yes, <br />� <br />approved credit may or may not cover full cast of requested City services. tiTax ID #: 80-0201690 <br />City Services Credit i <br />ykmount Requested: �S Date Needed: <br />_.._______ ....____.__ ...___.___._ _.._ <br />!Direct Payment Amount !$500 Q� �EvenY pate <br />,Requested. ! , <br />Ev�nttooatson I ALMA Science Academy <br />Address, City, state, Zip ;James Madison Elementary, <br />Time: <br />1124 E. Hobart St., Santa Ana, CA 92707 <br />IALMA: Aspire, Learn, Mentor & Achieve Science Academy <br />Description of I Youth academic enrichment and parental/resident engagement - offered during school year as <br />':EvenYlPurpas®, 1well as during the summer. <br />Promote science careers, strong academics and higher education among neighborhood as well <br />Community Benefit: !as parental engagement, civic participation and community building. <br />I <br />' r <br />'Applicant Signatures: -- <br />Mall: City Manager's Office- M31 Emall: donationrequest@santaana.org <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />P.O. Box 1966 <br />Santa Ana, CA 62702 <br />Revised 01/06/2017 <br />