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Adopt-A-Bench/Table Donation Form

  1. Adopt-A-Bench/Table Donation Form

  2. Donor Information

  3. Bench or Table Information

  4. Bench or Picnic Table*

  5. Please describe as specifically as possible.

  6. Please use exact wording, all uppercase. Up to 3 lines and maximum of 20 characters/spaces per line. Refrain from using profane, obscene or hostile words. While religious and political organizations may be recognized, no religious or political messages are allowed.

  7. Payment and Installation Details

    - Must include payment of $1,100 for each bench or picnic table.
    - Bench purchase and installation will be handled by Leb Rec to ensure uniformity.
    - Duration of time between receiving order and payment, and installation is about 2 months.
    - Memorial plaque will remain attached for the life of the bench or table.

  8. Payment Options*

  9. Leave This Blank:

  10. This field is not part of the form submission.