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Special Event Sign Application

Survey/Form Review
Town of Leesburg, Parks and Recreation Department Special Event Sign Application/Agreement
Name of Event

Organization

Contact Information
First Name
Last Name
Phone (H)
Phone (W)
Phone (Cell)
email
Mailing Information
Street Address
City
State
ZIP Code
Date of Event

Location of Event

I would like the following to be printed on each sign (24 spaces maximum)

I would like to advertise at the following locations (please check all that apply):
I would like to advertise during the following weeks: (week runs Monday-Sunday)

Special Event Sign Guidelines

(1) Application: A complete application and payment must be submitted at least 3 weeks
(and no earlier than five months) before signs are to be displayed.
Applications will be processed as first-come,first-served.
(2) Display: Advertising fee is $25 per week per sign. Signs may be displayed for up to six weeks prior to an event, for full weeks only.
A week runs from Monday-Sunday.
(3) Signs: Cost is $75 for a new sign or $35 for a revised sign. Signs are 8" X 9' white aluminum strips. Text is Times Roman Bold typeface, all capital letters, 6" high, forest green color,
24 spaces maximum. Signs remain the property of the Town of Leesburg.
(4) Payment is due at the time of the application by cash, credit card or
check (payable to the Town of Leesburg).

By submitting this form, I agree to abide by the rules and regulations set therin.
---------------FOR OFFICIAL USE ONLY---------------

________ New Signs @ $75 per sign = $________

________ Revised Signss @ $35 per sign = $________

________ Weeks X ________Signs @ $25/week per sign = $________

TOTAL = $ __________