Commemorative Bench Program
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I have read and understand the guidelines
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Donor Information
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Email
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example@example.com
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Bench Location Options
Desired Location
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Kercher Park Site #
Weber Park Site #
Plaque Inscription (Max of 2 lines - 32 characters per line
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