Business Name (As you would like it to appear on the Loudoun Farms directory):*
Applicant Name/ Business Representative:*
Phone:*
Email:*
Website
Please provide your logo (up to 2MB) so that we may cross-promote your brand:
Business Address:*
Address Line 2:
City/Town: *
Zip Code:*
Which Best Describes Your Business? Mark more than one if applicable
Please provide a short description of your product(s)/business as you would like it to appear on our website.:*
Eligible Products - For which Loudoun products would you like to use the logo? Please list.*
Collateral Requested (available only while supplies last - not guaranteed):
Where can your products be purchased?
APPLICATION ACCEPTANCE: I'm applying to use the LOUDOUN, VA MADE • LOUDOUN, VA GROWN™ logo, slogan and associated branding products in accordance with the trademark agreement and branding guide. I've read and agree to ALL policies and guidelines set forth by the Department of Economic Development.*