DATE: November 13th, 2021 (Second Saturday in November)

APPLICATION FOR:

BUSINESS, CHURCH, ORGANIZATION AND INDIVIDUALS

IF YOU WISH TO BE LISTED IN THE 15TH ANNUAL CHRISTMAS IN THE VILLAGE PROGRAM AND BE LOCATED ON THE MAP, PLEASE RETURN YOUR APPLICATION WITH DONATION PAYABLE TO CITV NO LATER THAN SEPTEMBER 01, 2021. IF WE DO NOT HEAR FROM YOU BY THEN WE WILL ASSUME THAT YOU DO NOT WISH TO PARTICIPATE.

OUR SINCERE THANKS FOR HELPING MAKE THEFESTIVAL ONE OF THE FINEST IN THE VALLEY!

Please return the bottom portion with your donation made payable to CITV by September 01, 2021 and mail to the above address.

Contact Person: Krisy Hendershot - 740-391-5485 or Shannon Sims - 404-455-7566

BUSINESS, ORGANIZATION, CHURCH OR INDIVIDUAL APPLICATION:

Business, Organization, Church or Individual Name:

Contact Name:

Address:

Phone Number:

Mobil/Cell Number:

E-Mail Address:

I will Participate____________________

I will not Participate___________________

Time I will open my store, business or booth:

Open Time:

Close Time:

Description of Participation:

I agree to hold Christmas In The Village of Powhatan, Inc., it's Officers and Associates harmless from any and all LIABILITIES.

Signature:

Print Name:

Date: