Memorial Application Form

Application for a dedicated memorial bench, tree or shrub

Please read the Memorial Benches, Trees & Shrubs Policy before completing this form. It can be viewed at: https://www.thametowncouncil.gov.uk/wp-content/uploads/2022/11/Memorial-Benches-Trees-Shrubs-30.8.22-1.pdf

Date of Application(Required)

Please notify us of any change of name or address so we can contact you if we need to.

Name(Required)

First Last

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Phone

Name of person for dedication:(Required)

Reason for dedication:(Required)

Preferred location:(Required)

Second choice location:

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Comments

This field is for validation purposes and should be left unchanged.