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2. CENTENNIAL BUSINESS OUTREACH FORM (2026)
4. 
5. Description

   In 2026, the City of Placentia proudly celebrates 100 years of history, heritage, and community. Local businesses are invited to participate in this once-in-a-century milestone by offering specialty items, promotions, or experiences inspired by Placentia's Cetennial.

   Participating businesses will be recognized as Centennial Partners and will receive a Centennial Partnership window decal.

   Please complete the form below to apply to participate in this historical event.

9. Business Information
11. Business Name*
12. Business Address*
14. Contact Name*
15. Website / Social Media
17. Phone Number*
18. Email Address*
22. Participation Details
24. How do you plan to participate in the Centennial? (Check all that apply)*

    1. Centennial-themed food, drink, or dessert
    2. Special promotion (e.g., Centennial Saturdays, Donut Tuesdays)
    3. Limited-edition product or packaging
    4. Retail promotion or window display
    5. Other
26. Brief Description of Your Centennial Offering*
30. Estimated Participation Timeframe
32. When do you plan to participate in the Centennial?*

    1. One-time promotion
    2. Multiple dates
    3. Ongoing during 2026
33. If known, please list dates:
37. Centennial Partnership Recognition

    Participating businesses will receive:

    • An official Centennial Partnership window decal
    • Recognition through City Centennial promotions (as available)

    Businesses are encouraged to share their participation on social media using our official hashtag:

    #Placentia100

41. Agreement

    By submitting this form, I confirm that my business would like to participate in the City of Placentia Centennial celebration.

43. Signature (typed accepted):*
44. Date:*
48. Submission Information

    Please return the completed form to:

    City of Placentia - _______ Department

    Email: _______

    Phone: ______

Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field