Required fields are marked with asterisks (*)

Memorial Order Form

Trees, benches, and picnic tables are important in our community as they provide our green spaces with shade and offer a place to enjoy nature. The Memorial Program encourages people to celebrate a loved one’s life or special occasion by purchasing a tree, bench, or picnic table to be placed in a town park.

This order form is the first step towards purchasing a memorial in a Town of Essex park or green space. For questions, please contact memorial@essex.ca or the Director, Community Services at 519-776-7336 ext 1109. Upon submission, a Member of the Community Services Department will contact you within three business days to further discuss your request

Memorial tree in park Memorial Bench in park Memorial Picnic Table

Memorial Tree - A donation of $500 covers: tree purchase, planting, maintenance, personalized aluminum tree tag, and standing engraved plaque.

Memorial Bench - A donation of $1500 covers: purchase, installation (including cement pad), maintenance, and an engraved plaque.

Memorial Picnic Table - A donation of $3000 covers: purchase, installation (including concrete pad), maintenance, and an engraved plaque.

What is your full name?

What is your full mailing address, including postal code?

What is your email address?

What is your phone number?

Memorial Tree, Bench or Picnic Table?

Memorial Tree - $500

Memorial Bench - $1500.00

Memorial Picnic Table - $3000.00

Requested location (please provide your most preferred location.)

Plaque inscription? Please note, the plaque is limited to 4 lines.

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Memorial Order Form