Virginia's Blue Ridge Partnership Form

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Business Name?* This field is required.
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Website
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Business Phone Number* This field is required.
Area Code
Phone Number
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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United States
Afghanistan
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American Samoa
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Anguilla
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Austria
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The Bahamas
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Belize
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Brazil
Brunei
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Canada
Cape Verde
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Central African Republic
Chad
Chile
China
Christmas Island
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Colombia
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Cote d'Ivoire
Croatia
Cuba
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Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
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El Salvador
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Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
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Gibraltar
Greece
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Guadeloupe
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Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
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Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Social Media - FacebookFacebook
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Social Media - InstagramInstagram
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Social Media - TwitterTwitter
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Name* This field is required.
First Name
Last Name
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Title
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Area Code
Phone Number
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Mobile Phone
Area Code
Phone Number
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Agreement* This field is required.Website listing, photos and events can be entered through our Partner Extranet. In providing images to Visit Virginia's Blue Ridge, you are acknowledging that you have the appropriate rights to distribute the images and are giving Visit VBR the rights to use the images on its website and other marketing materials. By clicking the box below, you are signing this form. Signatures on this partner enrollment form acknowledge permission being granted for Visit VBR to market and promote your business online and in print.
By clicking this box, I agree to all of the above.
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Date* This field is required.Please select today's date.
Date
Month
Day
Year
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Date of Establishment* This field is required.When was your business established?
Date
Year
Month
Day
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Last question! :) How did you hear about becoming a partner with Visit Virginia's Blue Ridge?* This field is required.
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