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25111WJAIT18 <br />Cay!danger's Office— Al -31 <br />i City of Santa Ana <br />20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />— (714) 647.5200 <br />am n. Dr. Ana Jlrnenez-Harm File, lExeculive Director <br />Pddros� s: 2215 North Broadway <br />Ity, stale, zip: ISanta Ana, CA 92706 phone: 714-547-5468 <br />mau: <br />ana@occtac.org Fax: 714-564-9690 <br />Nemo: Orange County Children's Therapeutic Arts Center <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as <br />1kgoloet Ono: <br />aflned under Section 501(c)(3) of the Internal Revenue Code? <br />If <br />Yes <br />O <br />No <br />IfNo, you W11 only qualify fora credit for Clyrelaled costs foryourrequest(le. permit fees, <br />If a <br />Tafftime,renalratesforfacOrtles or equipment etc.).CostsforCiyservicesvery endlf <br />ILf <br />33-0930891 <br />approved, credit may ormay not cover fullcost orrequested CityservIces. <br />(rax ID 0: <br />City Services <br />R�Dole <br />(ount <br />Needed: <br />June 11, 2018 layorlCouncllmombor. Sarmiento <br />Requested: I <br />Dl Payment Amount 1 000 <br />Event Oate: <br />June 15 2018 Ivan! 9:00 <br />qct <br />Rs coated: + <br />+ Tir- m -12:OOpm <br />vt Location: <br />�en <br />2215 North Broadway, Santa Ana, CA 92706 <br />d,osg City, MON. 7/p <br />OCCTAC DIgilai Ads Summer Camp kill leach youlh vdth and vrithoul special needs basic technology skills (grephie design, <br />onvideo <br />FE,,n't'1'Pu,poa,.- <br />6 photography), arts and Inclusive leadership training to youth vilth and vrithout disablktles from local Santa Ana middle <br />and high schools. The funds will be used to provide scholarships to studenlsnamilles to attend the camp at no charge. <br />Students will learn some great nnv skills that they con ulifize, for their future careers and education; and also be Inspired to <br />Community 8onelit: become Informed advocates and role models In their mmmuniy while providing Inslmction In occupational graphic design, <br />photography and visual arts skills. Most Importantly, students vAl be proud of their accomplishments and their parents too. <br />1 <br />Applicant Signature �l ::• °` -� _ une 8 <br />' !Data J 6 `201 <br />, <br />Mall: City Manager's Office—M•31 <br />20 Clvlc Center Plaza <br />rEmall;onallonrequeat(8senta•ena.org <br />714) 647.6854 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />,.. <br />Domi lon Request G .' <br />Relerencoeon arlreiata4OPUs' <br />MR c � <br />"''• I <br />�� <br />Council Mootlgg pato; <br />JUNE 19 2018 <br />Eligibility Mel: <br />YES/NO--YE5 <br />Approved Amount .'-�. <br />$1000 ` <br />City Manager Slgnaluro <br />- •' <br />Date: <br />Revised 01/0512017 <br />25111WJAIT18 <br />