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City Manager's Office- M-31 <br />(9) <br />C/ty of Santa Ana 20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 6475200 <br />Name: �OgaD CrOW <br />Address: 1305 E. 4th Street#1 - 00 <br />city, state, zip: Fs___ <br />anta Ana, CA 92701 <br />- — - <br />Email: ^ logan@thefridacinema.org <br />--- -- - <br />Title: <br />1Executive Director <br />Phone: 1(323) 428-7411 <br />'Fax: 1(866) 354-8617 <br />Name: [The Frida Cinema - (fiscal Sponsor: Long Beach Cinematheque) <br />Tax -Exempt Status: Is your organization a non-profit or public taxexempt organization as Select one: <br />defined under Section 601(c)(3) of the Internal Revenue Code? W-1YesQ No <br />If No, you will only qualify for a credit for City -related costs Por yourrequest (.e. permit fees, ,If Yes, <br />staff time, rental rates forfaciliffes or equipment,etc.). Costs for City services vary and if , 27-0950151 <br />approved, credit may or may not cover full cost of requested City services. Tax ID 9: <br />City Services Credit <br />,Amount Requested: <br />'$ ;Date Needed: 1NOV. 1, 2017 Mayor/Councilmember: Martinez <br />I I j <br />r--.____________ <br />Direct Payment Amount <br />s3 0 Event Date: [OV. 4, 2017 (Event Time: 1,2pm & 5:30pm <br />Requested: <br />Event Location: <br />he Frida Cinema/ 305 E. 4th Street #100, Santa Ana CA 92701 <br />lAddress, City, State, Zip <br />j <br />The Fnda Cinema will be welcoming Dolores Huerta, famed civil rights activist and co-founder of United Farm Workers <br />I(UF", <br />Description of <br />to Santa Ana with new documentary film "Dolores." Funds will be applied to two screenings and associated <br />Event Purpose: <br />lexpenses: a free screening open just to our community's female students, and a special ticketed screening, both of which <br />Ivnll be followed by an in-person discussion with Ms. Huerta. <br />T <br />We am proud to partner with Councilwoman Martinez and the City of Santa Ana in providing an opportunity to meet, _ <br />(face-to-face, <br />Community Benefit: <br />one of the most celebrated of American Civil rights leaders, and learn first-hand of herwork as an activist and <br />hilanthro Ist. Our screenings are also being held in the hope of inspiring future generations of females to take her <br />P P 9 9 P P 9 <br />Iiinspiring lead to effect change in their communities. <br />lAppiicant Signature: Date: <br />rMail: City Manager's Office -M-31 Email: donationrequesta@santa-ana.org <br />20 Civic Center Plaza Fax: (714) 647-6954 <br />1 P.O. Box 1988 <br />Santa Ana, CA 92702 J <br />I Donation Request n: DR - NOVEMBER 7, 2017 <br />Council Meeting Dater <br />Eligibility Met: YES I NO YES Approved Amount: $3,000 <br />City Manager Signature: Date: <br />Revised 01/05/2017 <br />29A-9 <br />