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City Manager's ORlce-M-31 <br />City of Santa Ana 20 Civic Center Plaza <br />-- iq - Donation Request P.O. Box 1988 <br />;l Santa Ana, CA 92702 <br />-=- (714) 647.5200 <br />• r r a p. • r <br />Naml e: <br />jDavid Poole 71ua: <br />Treasurer <br />Mdr s: <br />12241 Newport Avenue <br />Ity, State,iip: <br />North Tustin, CA 92705 ,Phone: 714-558-1921 <br />Final <br />dapoole@yahoo.com Fax: <br />...-lion information <br />(Name: <br />Santa Ana Kiwanis Club Foundation <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as Select One: <br />defined under Section 501(c)(3) of the Internal Revenue Code? Z Yes ElNo <br />If No, you will only quaily fora credit for City -related costs For yourrequest (i.e. permit fees, If Yes, -, <br />staff time, rental rates for faOdies or equipment, etc.).Costs for City services vary and it <br />(approved, credit may or may not cover full cost of requested City services. lax I #: ;95-6060395 <br />ity Services Credit Date �IMayorlCou�cllmember, <br />mount Requested: i <br />Sanniento <br />;Direct Paym ten�Am Amount <br />Event Date: thru Tune 2018 Event Time: <br />I1 $:30 PM <br />,Requested: <br />entLocauen: 510 E Katella Ave, Orange, CA 92867 Venue location for community event that <br />F <br />ress Cly,, state, Zip supports the youth involved with Kiwanis. <br />Community event to celebrate and engage youth and youth with disabilities, which <br />Description of <br />Event/ Purpose: <br />provides encouragement for youth education and self -empowerment. <br />Improve the community by enhancing the education, recreation and safety of <br />Community Benefit: young people <br />Applicant Signature: /—/t,(� (Date: (June 11, 2018 <br />. . •. <br />Mall: City Manager's Office -M-31 <br />Ematl, donationrequest@santa-ana.org <br />20 Civic Center Plaza <br />Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #: <br />RererenceW on all relatedDPVs <br />DR. <br />Council Meeting Date: I <br />DUNE 19, 2018 <br />Eligibility Met: <br />S1,000 <br />YESINO YES J Approved Amount: <br />City Manager Signature: <br />Date: j <br />Revised 011052017 <br />�J a`I_71 <br />