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2010 Timetravelers Site Application
YES, we would like to participate in the 2010 Virginia TimeTravelers program.
Name of Museum/Historic Site as You Want it Listed: *
Mailing Address *
City
State
Zip Code
Street Address (if different)
City
State
Zip Code
Telephone
Who will be the contact for this program? *
Telephone
Email
Please describe your site as it should appear in the book (80 words or less): *
Price of Admission
TimeTravelers discount offered? (not required)
Participation Level: *
If ordering more than 240 books, please enter the additional number here.
Shipping Method: *
Payment Method: *
Detailed Site Information
The following information will be used to list your attraction on the web site and passport.
What is your internet address?
Region:
City or Town:
County:
Primary emphasis of your site's interpretation:
HISTORY sites, please define the time periods your site represents:
Themes covered by your site:
Is any part of your site a designated Historic Landmark?
Please consider my site for the Minds Wide Open Theme. (see flyer for details)
Please place the Civil War Sesquicentennial logo in my entry. (see flyer for details)