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C <br />Y' <br />�^ddress: <br />ity, Stara, ZIP: <br />lEmen:• ­__.__, <br />City Manager's office—W31 <br />City of Santa Ana 20 Civic Center Plaza <br />Donation Request P.o. Box leas <br />Santa Ana, CA 82702 <br />(714) $47.5200 <br />Roman Reyna! Mario Rodriguez rtna: # Lead <br />PO Box 194 <br />San Clemente, CA 92674 <br />mrod2_6"S afioo.com or <br />p. <br />Name: � 13is anic 1pp Foundation <br />a Tax -Exempt Status: is your organization a non-profit o. <br />�, eflned under Section 501 (o)(3) of the Internal Revenue <br />as eaiect one: <br />Will only qualify for a credit for City -related costs for yourrequest (to. permit fees, Y <br />rental rates forfacilitles or equipment,etc.).Costs for City services vary and r7 [f -_.ss <br />credit may or may not cover full cost of requested City services. �Tax ID #: <br />(714) 865-9118 <br />® Yes 0 No <br />46-1962620 <br />Ity Services Credit <br />h3ate Neadod: <br />ASAP a ortCellmember. <br />oun�►aN"�V <br />,Amount Requested: <br />I <br />j <br />Direct Payment Amount <br />Requested: P 500 <br />vent Data: <br />on-going vent rima: <br />Event Location: <br />Address, City, State, Zip <br />Description of <br />Event / Purpose: <br />Community Benefit <br />!Applicant Signature: <br />Funds will help cover on-going cost for the youth program, but will specifically cover <br />the cost of conferences to prepyouth for legislation training in Nov., Jan., and Febr. <br />Many Santa Ana youth will participate in the Youth & Government Program and <br />activities that include training on how to create a bill and help it pass. There are three <br />upcoming conferences that will train youth and hlep them launch the bills. <br />.a Ana youth will become empowered by the education, leadership skills, that the <br />learn from the Youth & Government Program. This will also provide insight on <br />ilatiop,, networking, self-esteem, and public speaking skills. <br />_--- <br />ate 11/6/17 <br />Revised 01/0512017 <br />