Request For Event Planning Information
You may submit your request using this online form, or you may
print the form
and send to us.
Contact Information
Full Name:
Home Phone:
Work Phone:
Address:
City:
State:
Zip:
E-mail:
Sponsored by:
For Profit:
Yes
No
Event Information
Event Name:
Date of Event:
-
Time of Event:
Rain Date (if applicable):
Area:
- Select -
Aldie
Arcola
Ashburn
Bluemont
Dulles
Hamilton
Hillsboro
Lansdowne
Leesburg
Lovettsville
Lucketts
Middleburg
Neersville
Philomont
Purcellville
Round Hill
South Riding
Sterling
Waterford
Other
Location of Event:
Type of Event (example: circus, parade, fair):
Event Description:
Anticipated Attendance: Total:
Per Day:
Anticipated Participants: Total:
Per Day:
Supplemental Information
Select
Yes
No
N/A
Is the event Sponsor/Organizer registered with the Office of Consumer Affairs at the Virginia Department of Agriculture and Consumer Services?
Select
Yes
No
N/A
Does the Event Sponsor/Organizer have a Letter of Tax Examption from the IRS?
Select
Yes
No
N/A
Are you a professional/experienced event planner?
Select
Yes
No
N/A
Is this event in cooperation with an organization? (ie: Town, Parks and Recreation, Mall)
Select
Yes
No
N/A
Will food be served?
Select
Yes
No
N/A
Will tents be erected larger than 20 X 20?
Select
Yes
No
N/A
Will water be provided?
Select
Yes
No
N/A
Will any streets need to be closed?
Select
Yes
No
N/A
Will vehicular traffic be entering or exiting onto public road/roadways?
Select
Yes
No
N/A
Will traffic be blocked or rerouted?
Select
Yes
No
N/A
Will there be any use of fireworks, lasers, black powder or other pyrotechnics?
Select
Yes
No
N/A
Will there be alcoholic beverages?
Select
Yes
No
N/A
Will there be onsite camping?
Select
Yes
No
N/A
Are animals involved in any aspect of your event?
Select
Yes
No
N/A
Will any sales activity be conducted?
Select
Yes
No
N/A
Is there a plan for Emergency Medical Services reserved or on stand by? If yes, please specify:
Select
Yes
No
N/A
Is there a plan for trash disposal? If yes, please specify: (1) number of trash cans; (2) number of dumpsters; (3) collection frequency; (4) contact information for trash collector
Select
Yes
No
N/A
Is there a plan for collecting recyclables? If yes, please specify: (1) what will be collected for recycling; (2) number of recycling bins; (3) number of dumpsters; (4) collection frequency; (5) contact information for recycling collector (max 150 characters)
Special Note:
max 400 characters