Motorist Information Sign Program Application

* = required

Business Information

Business name*

Brief description of business / services offered*

Business type*

Corporately owned

Individually owned

Franchisee

Government

Is the location currently open for business?*

Yes

Website address

Number of miles from highway (approximate)

Highway number*

Exit number or intersection (approximate)

Contact Information

Contact first name*

Contact last name*

Email address

Phone number*

Fax number

Business location address

Address line 1*

Address line 2

City*

State*

Zip*

Business mailing address

Address line 1*

Address line 2

City*

State*

Zip*

Specify your business location by either clicking on the map or by using the region dropdown list.

State of Washington map having selectable regions.

Region dropdown list

Business operation days & times

*Is your business open 24 hours a day, 7 days a week?

Yes


	Sunday
open		close
	Monday
open		close
	Tuesday
open		close
	Wednesday
open		close
	Thursday
open		close
	Friday
open		close
	Saturday
open		close

Seasonal business (open only part of the year)?*

Yes

Business Activity

* I declare under penalty of perjury under the laws of the State of Washington that the information provided herein, concerning my business, its services, and operating hours, certify that the above statements are accurate and true. I also acknowledge that any discrepancy in such information discovered hereafter is cause for the Department of Transportation to revoke the motorist information sign permit and remove my logo sign.

Failure to meet these requirements or other MIS program criteria may result in the removal of a business's logo signs.