Bridge Lighting ApplicationSponsor/Applicant*Phone*FaxEmail* Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Points of ContactPrimary Contact Person* Phone*FaxEmail* Is there a second point of contact? YesSecondary Contact Person PhoneFaxEmail Choose your Bridge Lighting OptionsColor Selection: You may select one color for each light position shown above. The north and south side of the bridge will be identical. You may request a first, second, and third choice for each light position (For example: 1. Dark Blue/Light Blue/Purple). Please note: Primary Colors work best; pastels do not show up on the concrete surface of the piers.1.*2.*3.*4.*5.*6.*7.*8.*Choose your lighting type (Moving/Dynamic vs Static/Still)*Static (Lights will remain on for the duration of the display period)Dynamic 1 (Lights will alternate: even numbers on, odd numbers on, all on, and repeat)Dynamic 2 (Lights will cascade (1 on, then 2 on, then 3 on, etc.) on, cascade off, and repeat)Dynamic 3 (Lights will turn on and off in order (1, 2, 3, etc.), all turn on together, and repeat)Choose the appropriate item. Please note: Dynamic displays require considerable programming and, thus, higher fees.Choose Your Lighting Duration and Fee*1 Day Static - $1001 Day Dynamic - $1503 Days Static - $2503 Days Dynamic - $3501 Week Static - $5001 Week Dynamic - $6502 Weeks Static - $7502 Weeks Dynamic - $850*Please note that multiple day lightings are in sequential order. For example, if you would like to light the bridge for 3 days it must be for 3 days in a row. Multiple day lightings in non-sequential order cannot be discounted due to fixed bridge lighting costs associated with the changing of colors.Lighting date first preferenceStart Date* End Date* Lighting date second preferenceStart Date End Date Lighting date third preferenceStart Date End Date PublicityWith your permission we will post your lighting event to the WLB website calendar. You may include a short description about why you are lighting the bridge and your organization as well as a link to a website if you have one.What will your bridge lighting celebrate? (Please be concise as this will go on the WLB calendar)*Description of your organization and/or lightingIf you would like your event publicized on the Willamette Light Brigade website please include a brief description of your cuase, business or general reason for light the bridge.Website If you would like us to include a link to your website please provide the url here.* I understand that the WLB is under no obligation to publicly share details of a bridge lighting on any platform including website, social media or email. Any information shared is strictly for the interest of the public and/or sponsors whom have chosen to light the bridge and NOT to provide a platform for commentary of any type. Your lighting fees are strictly used for the lighting of the bridge and any additional services provided by the WLB are provided as a courtesy and not guaranteed.PLEASE BE ADVISED: The County will make a reasonable effort to create a lighting display approved by Willamette Light Brigade within the capabilities of the lighting system, consistent with your request. Due to the limitations of that lighting system, specific colors or light movements may not be obtained, so the County makes no guarantees about the accuracy of the colors or movements that will be displayed. If the dates you’ve chosen are not available or if bridge needs to be closed for maintenance or an emergency and prevents a special light display, those impacted will be notified and any deposit or portion thereof will be refunded if a future date or duration is not determined. Similarly, refunds may be arranged for any alleged or actual discrepancy or inadequacy of the final display.Signature*By signing you acknowledge you have read and accept the conditions and advisories in this application. This iframe contains the logic required to handle Ajax powered Gravity Forms.