Bench Dedication Application

All applicants for bench dedications are encouraged to contact the Parks and Green Spaces Department at 780-874-3700 to inquire about availability before beginning the application process.

Tax Receipt Information

*If not same as above.

Bench Location

Please list your top three (3) choices

Plaque Inscription

1. Enter your text in the boxes below, using a combination of upper- and lower-case lettering, to suit the message.
2. Indicate, if any, which line(s) of text you wish to have larger.
3. 30 characters maximum per line.
4. You do not have to fill in all the boxes.
5. Usually a minimum amount of text creates a more elegant message.

Once your application has been reviewed and accepted, an invoice will be issued. Upon receipt of payment, the plaque will be sent for engraving. The final draft of your plaque inscription will be returned to you for editing and approval. You will be notified when your plaque has been installed.

Note: The dedication term for a bench is 10 years from the date of installation of the bench and plaque.

Should you choose to print the form, please submit your completed application(s) to:

City of Lloydminster
Parks and Green Spaces
6623 52 Street
Lloydminster, AB  T9V 3T8

or email to parks@lloydminster.ca

Collection of Information

Your name and address are collected under the authority of section 25 of the Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP). This information will be used for the sole purpose for the City of Lloydminster Bench Dedication Program Application. If you have any questions about the collection, contact the LAFOIP Head at 780-871-8328.