Leaf a Legacy

Name of person giving the gift/memorial:

Name
Street Address
City
State/Province
Zip/Postal Code
Home Phone
E-mail

Name of person receiving the gift/memorial: (as it should appear on name plate)  

Name and address of receiver's next of kin:

Name
Street Address
City
State/Province
Zip/Postal Code

Proposed site where tree is to be planted:     Winter Park Choose one Carver Park Lincoln Park Garfield Park Ellsworth Park Elmwood Park Douglas Park Cannon Park South Gate Industrial Drive Harrison Park Golf Course Harrison Park Club House Other Public landscaped site:

Street or proposed site:  

         I would like to make a donation of $200.00 or less to be used toward a general tree fund.