Community Giving Program

Community giving program form

First and last name

Company (optional)

Phone

Address

Address 2

City/Town

State/Province

Postal Code/ZIP

Country

Person being honoured

First

Middle

Last

Donation type

Bench

Tree

Tree options

All tree options come with a standard plaque with 4 lines of text (max. 25 characters per line)

Plaque options for Bench (see examples above)

Font options

Font colour note: White text for night sky plaques. Black text for sandstone, dusk and glacier white plaques.

Provide the location for the memorial. Find details about locations

Location

Provide the wording for the plaque, please note, each line cannot exceed 25 characters.

Plaque

Line 1

Line 2

Line 3

Line 4

Important
You will not receive a confirmation from the Town of Georgina. Print this page as proof of registration before you press the submit button.

26557 Civic Centre Rd,
Keswick, ON L4P 3G1

T: 905-476-4301 / 705-437-2210
F: 905-476-8100
info@georgina.ca

Monday to Friday
8:30 a.m. to 4:30 p.m.