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2. Memorial/Heritage Tree and Bench Order Form

4. The City of Goodlettsville’s Parks and Recreation Department supports the Memorial/Heritage Tree and Bench Program to allow groups and individuals to donate trees and benches to commemorate special events, honor individuals or agencies, or as memorials to loved ones. These tributes are placed on city-owned park land. Trees and benches purchased through the program are planted and/or placed in city parks, trails, and playgrounds. Exact placement is at the discretion of the Parks and Recreation Department. More information can be found on our website

6. Contact Name
7. Please Select One*
   -- Select One --MemorialHeritage
9. Email Address*
11. Phone Number *
13. Address1
15. Address2
17. City*
18. State*
19. Zip*
23. Memorial/Heritage Bench

    The cost of a donated bench within the program is $1,500 per bench. The criteria for the site list are based on bench needs for each park, as well as a determination of the maximum number of benches appropriate for each park.

    • Before completing an application, the donor will contact Goodlettsville Parks and Recreation, to discuss bench style and placement options. 
    • Once the style and placement is determined, donor will submit application and payment.
    • Order time for benches is approximately 6 weeks.
    • Staff will contact donor when the bench is received to discuss installation timeline.
    • A bench will remain on park property until the life span of the bench is met (usually 10-15 years).
    • Benches or plaques that are damaged or stolen will not be replaced by Parks and Recreation.  If a donor wishes to replace the plaque or bench, it will be replaced at cost by the donor.
25. Bench Selection

    1. 6' Metal Bench ($1,500)
26. Park Requested
    -- Select One --Brooks ParkGateway ParkPeay ParkPleasant Green ParkMoss-Wright Park
28. Bench Location Requested

30. For each bench donation, a memorial or heritage placard will be placed on the bench.  This will include the type of donation, a short inscription, and the year of donation.

32. Inscription Request

    Limited to 4 lines with a 18 character max per line

34. Line 1

    (18 characters per line max)

35. Line 2

    (18 characters per line max)

36. Line 3

    (18 characters per line max)

37. Line 4

    (18 characters per line max)

41. Memorial/Heritage Tree

    Cost of a donated tree within the program is $300 per tree.   This includes the tree and planting, plaque, and continued maintenance of the tree (fertilizer, pruning, mulching, etc.).  Trees ordered will be high-quality 30 gallon, which is 8-12 feet tall, and 2” caliper.   Trees ordered from April 1 through October 15 will be planted in the late fall.  Trees ordered from October 16 through March 31 will be planted in the spring.

    • Donors may choose which park their tree is placed at, but no guarantee will be made as to an exact location of planting.  Placement is determined by the City’s Horticulturist.
    • Payment is due at the time the order with Parks and Recreation is placed.
    • After the tree is planted, the contact person will receive a certificate and map of the planting location for each tree.  
    • Trees that die within 1 year of planting will be replaced by Parks and Recreation with the same size and species of tree and at no charge to the donor.

     

43. Tree Selection

    1. White Oak
    2. Sawtooth Oak
    3. Bur Oak
    4. Swamp White Oak
    5. Sugar Maple

    1. Red Maple
    2. Redbud
    3. Tulip Poplar
    4. Norway Spruce
44. Park Requested
    -- Select One --Brooks ParkGateway ParkMoss-Wright ParkPeay ParkPleasant Green ParkNorth Creek Park
46. Tree Location Request

48. For each tree donation, a Memorial Tree Plaque or a Heritage Tree Plaque will be placed at the base of the tree.  These plaques will be a standard 4”x4” size and will describe the type of donation, a short inscription, and the type of tree and dedication year.  Parks and Recreation is not responsible for damaged, vandalized, or stolen markers.  These must be replaced at cost by the donor.

50. Inscription Request

    Limited to 4 lines with a 18 character max per line

52. Line 1

    (18 characters per line max)

53. Line 2

    (18 characters per line max)

54. Line 3

    (18 characters per line max)

55. Line 4

    (18 characters per line max)

59. Other Requests

    Check all boxes that apply

    1. Notification after installation
    2. Provide a photo of plaque/plate
    3. Provide a photograph of bench/tree
    4. Provide a map of the park or area showing location
    5. Other
61. If you selected "other" please specify your request
63. Payment

    Please make all checks payable to “City of Goodlettsville” and return via mail or delivery 

    Mailing Address: 

    • RE: Goodlettsville Parks & Recreation, 105 S Main Street, Goodlettsville, TN 37072

    Delivery Address: 

    • RE: Delmas Long Community Center, 200 Memorial Drive, Goodlettsville, TN 37072
64. Memorial/Heritage Tree and Bench Donation Program Policy*

    1. I Agree

    I agree to the terms of the Memorial/Heritage Tree and Bench Donation Program Policy. Click here to download a copy of the policy. 

Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

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