Loading...Order Date: ________________

(Please print legibly)

First and Last Name: ______________________________________________________

Address: _______________________________________________________________

City, State and Zip Code: ___________________________________________________

Contact phone #: _____-_____-_______

Contact Email Address for engraving confirmation: ______________________________

Please make check payable to “Virginia Capital Trail Foundation”

Check amount: _____________ Check number: ________

Sponsored Item: (circle one) Bench / Directional Sign / Mile Marker / Bicycle Rack

Brick / Interactive Kiosk / Ad Listing

Location Request: Trailheads are at James City Co., Charles City, and Richmond. Indicate if desired location is somewhere else. (e.g. “as close as possible to Berkley Plantation”).
Please list three choices in case some are not available.

#1:____________________ #2:______________________ #3_________________________

Sponsor Engraved message*: ________________________________________

*See website (www.virginiacapitaltrail.org ) for engraving specifications. By signing and dating below, you agree to the terms and conditions as listed on VCTF website.

Signature:__________________________________________ Date:____________________

Please mail this form and your check to the VCTF, Attention: Sponsorship Opportunities, PO Box 17966, Richmond, VA, 23226. Thank you for your generous support and becoming
a key stakeholder of the Trail.