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Residents
Commemorative Form
Updated: Nov 6, 2024
Commemorative Program Form
First Name
Last Name
Phone Number
Email
Address
Address 1
City
Postal Code / ZIP
Province / State
Will you require a tax receipt?
Yes
No
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Commemorative Options
Bench - $2,000.00
Tree - $600.00
Area
Cemetery
Park
Trail
Other
Location
Clifford
Harriston
Palmerston
Township
Other
Next
Back
Bench Colour (If Applicable)
Black
Gunmetal
Silver
Titanium
Tree Type (If Applicable) * indicates Native species ** indicates flowering ornamental
Ginkgo/Maidenhair Tree (Ginkgo biloba)
Celebration Maple (Acer x freemanii ‘Celzam’)
* Sugar Maple (Acer saccharum)
* Thornless Honeylocust (Gleditsia triacanthos inermis)
* Tulip Tree (Liriodendron tulipifera)
* White Oak (Quercus alba)
* Red Oak (Quercus rubra)
** Flowering Crabapple (Malus ‘Royal Raindrops’)
** Chanticleer Pear (Pyrus calleryana ‘Chanticleer’)
** Ivory Silk Tree Lilac (Syringa reticulata ‘Ivory Silk’)
Next
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Plaque Wording: Please use 120 characters or less
Comments?
Leave this field blank
Submit
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