Bench Donation Program

Bench Donation Program

Complete and submit, applications are accepted on a first come, first serve basis.
Application/Donor*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number*
E-mail*
example@example.com
Plaque Verbiage (Please double check all spelling.)
Requested Park/Site Name:
Request Bench Location (if possible, include photos - see below)
File Upload

Cancelof
Acknowledgement of Terms
The applicant/donor acknowledges that all donations to the Department of Parks, Recreation and Tourism will become property of Prince William County and the County reserves the right to remove or relocate all donated items at any time. In addition, the applicant/donor understands Parks, Recreation and Tourism will maintain the bench only for its useful lifetime. The bench will be removed when it becomes unsafe to sit on or if it is vandalized in a manner that makes it visually unacceptable. The Department of Parks, Recreation and Tourism will notify the donor when the bench must be removed and will give the original donor the opportunity to renew the gift and donate a replacement bench.
Should be Empty: