City of Milpitas City Council Non-Profit Donation/Fee Waiver Program Awardee Post Event Report

Within 60 days after completion of the event for which a donation was received or a fee waiver was granted by the City of Milpitas, your organization must provide a report to the Director of Recreation and Community Services.

Name of Organization
Organization Contact Name Organization Contact Name First Last
Organization Contact Email
Organization Contact Phone Organization Contact Phone - ### - ### ####
Event Name
Event Date(s) Event Date(s) / MM / DD YYYY
Event Location
Type of Award Received

Type of Award Received Donation Fee Waiver Amount of Award Amount of Award
Describe your event and its Benefit to the Community
Number of Attendees
Amount of Funds raised at your Event
Amount of Funds to be dispersed to the Community (required 60%)
Describe how Funds raised will be dispersed to the Community
Upload event publicity and media files demonstrating the acknowledgment of the City of Milpitas and its contribution.

Attach Files
I certify that I am an authorized agent of the above Organization and the information provided on this application is correct.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.