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+ N-2019-018-02 City Manager'sOflice–M-31 <br />City of Santa Ana 20 Civic Center Plaza <br />Donation Request Santa A a, CA 92702 <br />- _ (714) 647-5200 <br />Contact Information <br />ame: SCott Glabb 61e. lCoach <br />ddress: 17 77 Pitcairn Dr _ <br />Ity, state, Zip: Costa Mesa hone: 714-609-6607 <br />1 <br />_ <br />leman: scott.glabb@sausd.us �VFau: --'. 714-567-4997 <br />iOrganization Information <br />1 <br />Name: Orange County Grappling Fiscal Sponsor will be Santa Ana Athletic Foundation <br />Tax-Exempt Status: Is your organization a non-profit or public tax-exempt organization as elect Ona: <br />RYes No <br />defined 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 (i.e. permit fees, —i <br />Yes, <br />staff time, rental rates for facilities or equipment, etc.). Coats for City services vary and if f <br />�'ax 91-2163665 <br />approved, credit may or may not cover full cost of requested Co services. ID #: <br />!Donation <br />Ity Services Credit ate Needed: X2/11/2018 ayorfCouncllmember; Pulido i <br />`Amount Requested: t <br />Pirect Payment Amount 000.00 Event Data: Mons & Wi vent Time: 6PM <br />lRequested: <br />SmU Ma High SGwail Wr$gUirp Roan ' <br />Event I.00etlOn: <br />520 W. W2 al <br />Address, City, State, Zip <br />Santa Me, 0A 92701 I. <br />Every Monday and Wednesday at bpm we provide free wrestling instruction and tutoring for kids <br />Description of <br />grades K -12th. The funds will be used for entry fees to compete in wrestling tournaments, as <br />Event l Purpose: <br />well as gear and food for the wrestters(participants. <br />Orange County Grappling Club specifically exists to give hope and purpose to adolescent boys and girls in Santa Ana. <br />Community Benefit: <br />CThe benefit to the community is to empower and enable these adolescents to reach their highest potential and to achieve <br />their goals in life. Thus, making positive contributions back to the city. We also exist to redirect negative behaviors toward <br />1 <br />positive antlers, 'teaching teens to wrestle through their aggressions and the pain that daily life may bung <br />'Applicant Signature. <br />J <br />F4 I <br />= • w aHolz "'-` <br />(� <br />Return • • - •- form via, <br />Mail: City Manager's Office–M-31 <br />Emall: donationrequest®sants-ana.org <br />20 Civic Center Plaza <br />Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />$S Emil i _ <br />Donation Request #: OR - <br />Reference # on elt reiatetl tMVs council Meeting Date: 112/4/18 <br />I i <br />Eligibility Met: YES / NO Yes Approved Amount: - $1,000 l <br />City Manager Signature: <br />-- -- – – -- <br />EXHIBIT 2 Revised 01/05/2017 <br />