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City of Santa Ana <br />a,rt <br />Donation Request <br />City Manager's Orrice - M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5100 <br />e • r Sr 3 �.- <br />- <br />•i <br />Name: Danny Garza <br />•Title: <br />1 <br />Address: 11522 W Washington Ave <br />loved ones that have lost their fight. <br />City, state, Zip: I Santa Ana, CA 92706 <br />Phone: <br />714-206-9084 <br />Email: I adxgarza@yahoo.com <br />'Fax: <br />Applicant Signature; <br />Dasa y r�.Zr7. +Date; <br />2�s/Za <br />�Name: American Cancer Society (ACS) <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as <br />Revenue <br />iSelect One: <br />Yes No <br />❑ FJ•defined <br />under Section 501(c)(3) of the Internal Code? <br />l <br />If No, you will only quality for a credit for City-relafed costs for yourrequest (i.e. permit (ees, <br />staff time, rental rates for rectlities or equipment.etc.).Costs for City services vary and l/ <br />' <br />If Yes, <br />13-1788491 <br />approved, credit may or may not cover full cost of requested City services. <br />1Tax ID 0: <br />City Services Credit � <br />Amount Requested: Date Needed: 106-01-2018 MayorlCounclimember, Tina)ero <br />? <br />Direct Payment Amt <br />tr:enAmount I$ 500 Event Date: ! O6 -Z3 -Z018 Event Time: 2:00 pmI <br />Requested: I r I <br />Event Location: 11940 East Deere Avenue, Santa Ana, CA 92705 <br />!Address, city, State, Zip <br />Relay For Life is a 24 hour event for all ages that focuses on solidarity and fundraising for the fight against cancer, <br />Description of <br />i We celebrate and pay tribute to people that have conquered cancer, support those that are still fighting, and remember our <br />Event I Purpose: <br />loved ones that have lost their fight. <br />Bringing the community together to raise money for The American Cancer Society (ACS) wig help with research, transportation, <br />Community Benefit: <br />dodging; and many other programs that are offered to cancer patients free of charge. This also benefits the community by bring 1 <br />awareness that they are not alone while dealing with cancer and allows us to share the resources provided by ACS. <br />Applicant Signature; <br />Dasa y r�.Zr7. +Date; <br />2�s/Za <br />e <br />Mail: City Manager's Office -M-31 Email: donationrequest@santa-ana.org <br />20 Civic Center Plaza I Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />DI-nni ell Roquust N, <br />F ligih,lily INnY <br />City Manager eignetme: <br />Y1=51 nip YES <br />i'nunnl Modal!! Pat". <br />April 17, 2016 ' <br />Appi•.rverl ilmnuiil $500.00 <br />-11 <br />Uuu:: <br />Revised CIICM017 <br />