Fillable Park Bench Donation Program Form 6.7.19

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Park Bench Donation Program Form 6.7.19

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Park Bench Donation Program
The City of Medina Park Bench Donation Program
enables people to donate an 8-foot bench for $1500 to
any Medina city park. Donating a bench is a personal
and generous way to honor a loved one and contribute
a lasting gift to the community. Your contribution may
be tax deductible. See your tax advisor.
The 8’ benches are made of recycled plastic planks
attached to bronze powder coat metal frames and
mounted in a concrete base. The 2.5” x 10” cast-
bronze plaques are flush mounted into the bench.
Price includes the custom plaque.
For more information, please contact City Hall at 763-473-4643.
GENERAL INFORMATION
Name
Address
Phone Number
Preferred Park
PLAQUE INFORMATION
Print the exact wording for the plaque (Maximum 3 lines)
Line 1
Line 2
Line 3
Make checks payable to the City of Medina and mail with the form to:
City of Medina
Park Bench Donation Program
2052 County Rd 24, Medina, MN 55340
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Park Bench Donation Program Form 6.7.19

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Completed 13 July 2020

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