Commemorative Bench and Tree Request Form

Required fields are marked with asterisks (*)

Please fill out the online form below to submit your request for a commemorative bench and/or tree.

First Name

Last Name

Address

Town

Postal Code

Telephone

Type of Bench Requested (Park, Cemetery)

Requested Location (Parks, Green Space, Cemetery - please include address and name of park)

Plaque Information (Name, Date, Verse - 10 word limit)

Total Payment

Applicant's Signature

Clear

Date

Pool opening June 27th