Bench and Picnic Table Sponsorship Application

First Name *

Last Name *

Phone *

Address 1

City

State/Province

Zip

Sponsorship Information: (please indicate bench or picnic table)

Email *

Visit www.acparks.org/benchsponsorship for locations

Preferred Park or Trail Choice: #1 *

Preferred Park or Trail Choice: #2

Preferred Park or Trail Choice: #3

Name of person being honored.

Proposed Text for Plaque (in accordance with the policy): Examples below.

A gift in memory of Sue Smith. A wonderful friend who loved to garden.

A gift in honor of your 50th Wedding Anniversary. Bob and Sue Smith

Your message may include:

4 rows, 20 characters maximum per line (punctuation and spaces included). Provide your desired text written exactly how you would like it to read. The plaque manufacturer may suggest changes to improve readability.

Requested date of installation:

The American Canyon Community and Parks Foundation is a 501(c)3 non-profit organization. Your sponsorship of a park bench or picnic table may be tax-deductible. Please make your check to: “American Canyon Community and Parks Foundation”: and return this form and payment to:

American Canyon Community and Parks Foundation (ACCPF). 101 West American Canyon Rd. Suite 508-102 American Canyon, CA 94503. Please contact us for payment options by Credit Card

I have been given and read, fully understand, and agree to abide by the Bench and Picnic Table Sponsorship Program Policy. My signature below indicates that I have read this document in its entirety and I understand that: Parks and Recreation Department managers make all final decisions, including but not limited to availability, locations and bench/picnic table style. All language used on recognition plaque is subject to approval. As a tax-deductible sponsorship, all donated benches or picnic tables are the property of the City of American Canyon and will be maintained according to Parks and Recreation Department Guidelines.

Signature of Donor

Date

Timeout Warning

Bench and Picnic Table Sponsorship Application