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City of Santa Ana <br />i Dartatiofl Request <br />Cfly Mannyet'r Office-td•9i <br />20 Civic Ccntor Plaza <br />P.O.pok 19178 <br />Saote Ana, CA 92707 <br />1714} 647.5200 <br />Y <br />Name: Nati Alvarado This; Executive Director <br />Address: 1920 E. 17th Suite 202 <br />city, tate, zip: Santa Ana Ca. 92705 phone: 714-267-7747 <br />small: nati@ngservices.org Fax: <br />Name: Natis House DBA Nuetral Ground <br />Tax -Exempt status: Is your organization a non-profit or public lax -exempt organization as Select One: <br />defined under Section 501(c)(3) of the internal Revenue Code? V Yes No <br />ifNo. you wig only quallry for a credit for Cily-niltued costs for your request (te, permitlees. it Yes <br />staff time, rental rates for facilities or equipment, arc.}, Costs for City services very end if 45-4041042 v✓ <br />approved, credit may or may not cover full cost of requested Ciry services. Tex IO 4e <br />tt ?� xc<:,;zsi'#G. '�'�.$y ?u s'�- *s''fi, �Y#<. a-'.L2�,� .�ns¢_,3'•',,. '.c� .-°.<§.rn`:'.. 'e `,,e to=Fy, Ai„L" <br />City SsMass Credit It 11000-0 rate... 03/26/2017 a <br />lorio <br />Amount Requested: <br />Direct Payment Amount 11,000.0 Event bate: every Sat EvantTlmo:6:00pm <br />Requested: <br />Event Location: 1920 E. 17TH St, Santa Ana, Ca. 92705 <br />Addr ie s, C4,, MO& Zip <br />Youth gathering, bringing youth together from throughout Santa Ana. <br />Description or Youth are provided with valuable life skills information by positive role models. <br />Event l purpose: <br />By bring our youth together into a neutral place, our youth will be able to meet <br />community eermilt: others which will in turn break down the barriers that we have in our city. <br />'Youth Vogram services include mentoring, life skills, and community resources. <br />9 <br />Applicant Signature:Date: 03/2312017 <br />Mail: City Manager'sOrflce-M-31 Email: donotionrequestCtana-gna,org <br />20 Civic Center plata Fax: (114)1476914 <br />P.O, Sox lose <br />Gama Ana, CA 92702 <br />T 1OW, <br />