Sponsors, if any_______________________________________________________________________________________
Please
describe your activity or event in detail, and how this event, project,
publication or program promotes the theme of Augusta County's Jamestown
2007 project If more than one activity, please copy this form to describe other activities.
OPTIONAL
ONE-TIME DONATION ____ Yes, we will help defray the cost
of processing, printing materials, website listing and advertising for
including our activity with a contribution of $_____. Please
consider a donation of $30 (actual cost to provide this service for
you) or more to assist in providing a successful program for our
residents and visitors during the Augusta-Jamestown
commemoration. Thank You! Please make check payable
to: Augusta-Jamestown 2007
WAIVER:
Augusta County Jamestown 2007 Community Program assumes no liability
for incidents associated with this event, project, publication or
program. Application fee is non-refundable and non-transferable. SIGNATURE_________________________________________________________ Date_________________________
Please return completed form with check by May 31, 2006 to
Augusta-Jamestown 2007, P O Box 590, Verona, Virginia 24482
