City of Portland
Department of Public Services
Forestry Section

'Memorial & Gift'  Tree Program Registration Form - 2010

Print this page and mail or fax to:

Memorial & Gift Tree Program
55 Portland Street
Portland, Maine 04101
Phone 874-8801    FAX: 874-8816
 

Donors Name: ______________________________________________________

Street Address: _____________________________________________________

Phone (HOME): _____-____________ Phone (WORK): _____-_______________

E-Mail Address: _______________@_____________________.______________

(  ) Tree planted in memory of: or  (  ) Tree planted as a Gift to:

Name: ___________________________________________________________

Planting Site Options:  City Park  (    )_________________________________

Other: ___________________________________________________________

Location Info: _____________________________________________________

Donation amount to 'Portland Tree Trust': $__________.  # of Trees:

Tree type : ________________________________ Size____________

Date of  Purchase: ________/________/ 2010

Date of  Actual tree planting: ________/________/ 2010

Special Requests/Notes: ________________________________________________

___________________________________________________________________

Memorial & Gift Trees are planted during the months of May & June Only.