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City of Santa Ana <br />' Donation Bequest <br />�Uame: Roman Reyna/ Mario Ro, <br />�ddresa: p0 Box 194 <br />Ity, 8tato, ZIP: San Clemente CA 92674 <br />Emah: mrod262@yahoo.com or <br />Name: I Hispanic 100 Foundation <br />wn•cxen,p� mama: is your organization a non-profit or public tax-exempt organization a <br />lefined under Section 501(c)(3) of the Internal Revenue Code? <br />If No, you will only qualify for a credit for City -related costs for your request (l. e. permit fees, <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and If <br />rpproved, credit may or may not cover full cost of requested City services. <br />City Manager's Office — it <br />20 Civic Canter Piaza <br />P.O. Box 1988 <br />Santa Ana, CA 93702 <br />(714) 847.5200 <br />Lead Advisor <br />( hone: (714) 865-9118 <br />Fax: <br />elect One: <br />Yea ❑ No <br />Yes, <br />ix ID#; 46-1962620 <br />ty Services Credit <br />Amount Requested: 6 Date Needed: ASAPMayor/Councilmembor. <br />Requested: Amount 7 <br />�tt5zo (Event Date: on-going �N— 1E1 <br />ent Time:* <br />immOn-gOlrig-_-�_.,._._._ <br />Event Location: Fundss wiill help cover on-going cost for the youth pro-Futw1Irspecir1ica1Ty co6er <br />Address, City, state, zip [the cost of conferences to prep youth for legislation training in Nov., Jan., and Fehr. <br />Description of Many Santa Ana youth will participate in the Youth & Government program/activities <br />Event/ Purpose: that include training on how to create a bill and help it pass. There are three upcoming <br />conferences that will train youth and help them launch the bills. <br />Santa Ana youth will become empowered by the education, training, anVeadersfiip <br />Community Benefit: skills, that will learn from the Youth & Government Program. This will also provide <br />msigh� n legislation, networking, self-esteem and public speaking skills <br />[AP Slgnatum t Aate: 11/6/17 <br />Mall: City Manager's Office—M-31 Email: donationrequest@santa•ana.org �. <br />20 Civic Center Placa Fax: (714) 647.6954 <br />P.O. Bex 1988 IIIfI <br />Santa Ana, CA 92702 1- <br />I council Illaeaing Daae: December 19, 20017 <br />,Approved Amount: $1,500 <br />Data: <br />Revised 01/05/2017 <br />