Form Center

2. Complete and submit the form below. All applications are accepted on a first come, first serve basis. 
4. Contact Information
6. First Name*
7. Last Name*
9. Phone Number*
10. Email Address*
12. Address 1
13. Address 2
15. City
16. State
17. Zip Code
19. Contingency Contact

    Please Note: Contingency Contact information will be securely stored for potential future notification or in case of emergencies.

21. First Name
22. Last Name
24. Phone Number
25. Email Address
27. Donated Item*
    -- Select One --Bench ($5,000)Tree ($2,500)
28. Requested Park/Site Location*
30. Bench Plaque Verbiage

    The bench plaque may have up to 4 lines of text with 14 characters per line.

32. Line 1
34. Line 2
36. Line 3
38. Line 4
40. Acknowledgement of Terms*

    The applicant/donor acknowledges that all donations to the City of Snohomish will become property of the City and the city reserves the right to remove or relocate any and all donated items at any time. In addition, the applicant/donor understands the city will maintain the bench only for its useful lifetime. The bench will be removed when it becomes unsafe to sit on or if it is vandalized in a manner that makes it visually unacceptable. The city will notify the donor when the bench has to be removed and will give the original donor the opportunity to renew the gift and donate a replacement bench.  

    1. I acknowledge
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field