________________________________________________________
-------------------------------------------------------------------------------------------------------------
Queen’s Park Memorial Bench Scheme
Nomination Form: For a Memorial Bench to be gifted to Rochdale Council for
installation at Queen’s Park
Name: ________________________________________________________
Address: ________________________________________________________
Tel No: ________________________________________________________
Bench allocated (Number): ________________________________________
Plaque Inscription (Capital lettering unless otherwise indicated):
(Maximum 120 characters including punctuation and spaces)
Cheques should be made payable to Rochdale MBC. This will pay for the
bench (cast iron heritage design with hardwood laths) purchase, memorial
plaque purchase, bench installation and maintenance of the bench for a
period of 10 years.
At the end of 10 years you will be contacted again to see if you wish to
purchase another 10 years of maintenance (current cost £410) or have the
plaque removed and the name / donation / inscription placed on a Memorial
Roll thanking people who have donated a bench.
Please send this form and cheque to:
Ian Trickett
Environmental Management Headquarters
Green Lane, Heywood
Rochdale, OL102DY
If you have any queries about the Memorial Bench Scheme, please contact
Phillip Georgiou, Tel 01706 922047 or e-mail
Phillip.Georgiou@Rochdale.Gov.uk You can also pass this Memorial Bench
request via the Friends of Queen’s Park.
Office use only
Cheque received:
Date bench Installed:
