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Green Light Tracking Form Your Name:____________________________________________________________________________________________ Name of Organization/Business:____________________________________________________________________________ Contact Person:__________________________________________________________________________________________ Address:________________________________________________________________________________________________ Phone:_________________________________________________________________________________________________ Email:__________________________________________________________________________________________________ Social Media Account(s):___________________________________________________________________________________ (Ask what platform they are on – Facebook, Instagram, Twitter? We can tag them on our social media sites). Lighting Options*: Green Light bulb 40 Watt Candle Bulb Candle for window (suction cup) and candle bulb Green String lights Spotlight Flood Lights for larger windows Special Note--If they request a Green Filter ask: How many lights need covered:________ Approx. diameter:_____________ (We have some sheets of Green Filter that we can provide to place over the existing lights) Signage: Indicate if signage is needed & size (flyer/poster size):__________________________________________________________ Special Notes—Please include your store days and hours: Please return your form to Colleen Igo at Cigo@YorkCountypa.gov by Friday, April 22nd so that we have enough time to order your bulbs. (Or, if it is more convenient, you can take a pic/scan, then text it to 717-324-1012). Thank you for your prompt response. *Supplies are limited; but we will do our best to accommodate all lighting and signage requests.