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IIT 9 <br />-21 <br />i1E Cit of Santa Ana <br />- <br />City Manager's Office -M-31 <br />20 Civic Center Plaza <br />Donation Request <br />'•-_ <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647-5200 <br />e o 0 <br />!Name: Zeke Hernandez <br />�fitle: President <br />--- —��— <br />Address: 1P0 Box 1810 '------ - <br />_—,._ <br />;city, state, zip: Santa Ana, CA 92702 <br />Pnene: x714-581-1549 <br />1Eman: zekeher@yahoo.com <br />1Fax: <br />0 • , a o a <br />County (as fiscal sponsor for Santa Ana LULAC) <br />1 Name: Ser -Jobs for Progress of Orange <br />(Tax -Exempt Status: Is your organization anon -profit or public tax-exe <br />'defined under Section 501(c)(3) of the Internal Revenue Code? <br />pt organization as elect One: <br />� Yes ❑ No <br />IIIf No, you will only qualify for a credit for City -related costs for your request <br />StaBdme,rentalratesforfacilities or equipment,etc.).Costs for City services <br />— <br />(i.e. permit fees, r--"-�-' '- - - <br />vary and if If Yes, <br />/approved, credit may or may not cover full cost of requested City services. <br />Fax 10#: g5-2549622 <br />D• o • <br />IClty Services Credit <br />IAmountRequested: jDate Needed: (asap <br />I --- - -- <br />iMayorlCouncilmember.-Solono <br />1- <br />Dirgct Pa Ment Amount - -_-- � �- --- <br />IRe uested: P500 iEvent Date: 111/4/1 <br />— -- <br />iEvent Time: 6pm-1 Opm - <br />1Event Location: Ebell Club 625 French Street, <br />Santa Ana, CA92701 <br />iAddress, City, State, Zip <br />OC Hispanic Women Reco <br />(Description of I p g <br />Rion Awards Dinner 1 <br />(Event I Purpose: <br />1 <br />the lives of <br />'Community Benefit:Improving young <br />Students and women through college education <br />i(support, recognition and accomplishment <br />events. <br />- / <br />Applicant Signature: <br />—------- -------.------ <br />Date: f <br />OI <br />10/11/17 <br />7 <br />IqI.1III <br />1 <br />I <br />IMatl: City Manager's Office -M•31 <br />jEmail: donationrequestClasanta-ana.org <br />i 20 Civic Center Plaza <br />I <br />Fax; (714) 647-6954 <br />P.O.Box 1986 <br />1 <br />San <br />Santa Ana, CA 92702 <br />i <br />Donation Request 1. IDR. <br />...I <br />Council Meeting Date: NOVEMBER 7, 2017 <br />Eligibility Met: YES i No YES <br />Approved Amount: $500 <br />I <br />City Manager Signature: <br />I I <br />I Date: <br />Revised 0110 512 01 7 <br />IIT 9 <br />-21 <br />