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Application for Town Businesses:
Voucher Program, Social Distancing Directory, Purcellville Strong Features

  1. Briefly describe your business (i.e. restaurant, farm, beverage, retail, etc.) and the main goods or services you offer.

  2. VOUCHER PROGRAM

    The Town of Purcellville will be distributing two $10 vouchers to be used at participating businesses in Town through December 31, 2020. Businesses that would like to participate must have a Town of Purcellville business license. Businesses that accept the vouchers will turn them into the Town of Purcellville for reimbursement. Complete the section below if your business is willing to participate in this program to accept the vouchers. After the application has been received and the business license has been confirmed, your business will be listed in an online directory for those that are accepting the vouchers.

  3. My business will participate in the voucher program*

  4. DIRECTORY OF BUSINESSES OFFERING SOCIAL DISTANCING OPTIONS

    Complete the section below to be listed in the online directory of businesses offering social distancing options.

  5. Special Options*

    Please check off the options you offer for providing goods/services.

  6. PURCELLVILLE STRONG FEATURES

    The Town of Purcellville has initiated an effort called Purcellville Strong with a series of virtual events, activities, and features published on the Purcellville Parks and Recreation Facebook page. Tuesdays and Fridays are dedicated to featuring local businesses, organizations, musicians, and artists. If you are interested in being featured, check yes below.

  7. We would like to be featured and agree to provide a 3-minute video to be published on the Purcellville Parks and Recreation Facebook page*

  8. Leave This Blank:

  9. This field is not part of the form submission.