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City of Santa Ana <br />Donation Request <br />.. ._ - _—__..,. <br />Name: --- EDavid Poole TWO: <br />��lddreaa: �12241 Newport Avenue <br />6ty, State, zip: North Tustin, CA 92705 ;Phone <br />i <br />tB.. .[dapaole@yahoo.com ..._IraX _. <br />Santa Ana Kiwanis Club Foundation <br />City Manager's Office — M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />14-558-1921 <br />npt status: Is your organization a non -pram or pupuo tax-exempt organization as (Select One: <br />ider Section 501(c)(3) of the Internal Revenue Code? I I Yes El <br />No <br />will only quaW fora ctadit for City -related costs for your request (i.a. permit fees, <br />rental rates for facilities or equipment, etc.), Costs for City services vary and if <br />credit may or may not cover full cost of requested City services. <br />pity Services Credit Pate Needed: <br />;Amount Requested: <br />Amount <br />Location: <br />s, city, state, zip <br />Yes, <br />ix ro n: 95-6060395 <br />nc0member: I Sarmiento <br />S 1000 Event Date: thru June 2018iEvent Tile, 5. d PM <br />_. -- <br />1510 E Katella Ave, Orange, CA 92867 Venue location for community event that <br />supports the youth involved with Kiwanis. <br />'Description of Community event to celebrate and engage youth and youth with disabilities, which <br />Event) Purpose: 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 ^�J/','s,�'� <br />iApplicant5ignatura: ate: <br />IJune 11 r 2018 <br />i <br />' <br />Mail: City Manager's Office—M-31 <br />20 Civic Center Plaza <br />P.O. Box 1980 <br />Santa Ana, CA 92702 <br />Donation Request <br />rYcierartre & �,, &I rOawd bpV': <br />Eligibility Met: <br />City Manager Signature: <br />donationrequest Tanta-ana.org <br />(714) 647-6964 <br />DR _.._ .-._ Council Meeting Data: _. <br />YES! NO Approved AmounC <br />D,7w L j <br />Revised 0110512017 <br />