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Memorial Bench Donation Application Form

Thank you for your interest in donating a memorial bench. Please fill out the form below to submit your application.

Donor Information

Full Name

Mailing Address (including town and postal code)

Email Address

Phone Number

Personal information contained on this form is collected under the authority of the Municipal Act, 2001 for the purpose of creating a record to be used for considering and administering a Memorial Bench and Plaque Donation Program and to correspond with the person responsible for the donation or purchase. Questions about the colleciton of this information should be directed to the Clerk.

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Memorial Bench Donation Application Form

Donor Information