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Memorial Bench Application Form

  2. (xxx) xxx-xxxx
  3. Locations:
  4. Please note that in an event beyond the control of the City of Chestermere, the City reserves the right to relocate this memorial bench.
  5. Billing/Invoicing Information (The Cost of a Memorial Bench is $1900.00 plus GST)
  6. First and Last Name
  7. (xxx) xxx-xxxx
  8. This personal information is being collected for activities related to applying for, paying and installing a Memorial Bench for the City of Chestermere, and as such is deemed to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)c of the Freedom of Information and Protection of Privacy Act, and will be used only for the purpose identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at City Hall, 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207-7050.
  9. Leave This Blank:

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