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2. VILLAGE OF ROMEOVILLE COMMEMORATIVE PROGRAM

   
   

   Park Tree Application Form

   Created February 26, 2021

4. Description:
   The Village of Romeoville is offering a unique opportunity for residents to honor a current or former community member through the Commemoration Program. The program is utilized as a way to recognize individuals that have made a significant contribution or impact on the community.
6. APPLICATION PROCESS
   The nominator should complete and submit the form. The Committee will then make a recommendation to the Village Board. Each application must meet the criteria as set forth, although meeting all criteria does not ensure naming rights. The Committee has the right to deny any application for any reason at any time or waive requirements as set forth. Applications with names or nick names that endorse or advocate religion or specific religious beliefs, have obscene connotations, or demean or attempt to intimidate any group based on the group’s race, ethnicity, age, gender, disability, or sexual orientation will be denied.
   Fee for park tree and park bench can be submitted via check payable to the Village of Romeoville. Mail to: Village of Romeoville, 1050 W. Romeo Rd, Romeoville, IL 60446 Attn: Dawn Caldwell.
8. QUALIFICATIONS
   To qualify, the honoree must be a former or current Romeoville resident and successfully passed a background check.
10. SELECTION
    The completed form will be reviewed to determine if all criteria has been met. If all criteria has been met, the nominee’s application will be forwarded to the Commemorative Program Committee which consists of an elected official, the Village Manager, a Village of Romeoville employee, a Non-profit representative and a Romeoville resident.
12. NOTIFICATION
    If honoree is selected, the Committee will inform the nominator and the honoree via letter.
14. Continue

NOMINATOR INFORMATION

2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Home Phone
12. Work Phone
13. Cell Phone
15. Name of Honoree
16. Relationship to Honoree
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HONOREE INFORMATION

2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Home Phone
12. Work Phone
13. Cell Phone
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QUALIFICATIONS

2. Is honoree a current Romeoville resident?

   1. Yes
   2. No
3. If yes, please indicate the year the honoree moved to Romeoville:
5. Is honoree a former Romeoville resident?

   1. Yes
   2. No
6. If yes, please indicate the years that the honoree lived in Romeoville:
8. Please indicate the last four digits of driver's license number in order to complete the background check:
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TREE SELECTION

2. Commemorations can be made by purchasing a tree. Park trees are $350 and includes the tree, delivery, installation, commemorative paver and maintenance. The tree will be planted in a Village park with the final location selected by the Recreation Department, based on the nominator's requests. An engraved paver will be placed at the base of the tree after growth has been established.
4. Please select the tree species desired:

   1. Emerald Queen Norway Maple - 50'h x 40' w
   2. Crimson King Norway Maple - 50'h x 40' w
   3. Sugar Maple - 50'h x 50'w
   4. Shademaster Honeylocust - 50'h x 30' w
   5. Redmond American Linden - 60'h x 35'w
   6. Homestead Smoothleaf Elm - 60'h x 35'w

   1. Prairie Fire Crab - 15'h x 20'w
   2. Snowdrift Crab - 20'h x 20'w
   3. White Oak - 60'h x 40'w
   4. Red Oak - 60'h x 45'w
   5. Colorado Blue Spruce - 60'h x 20'w
   6. Scotch Pine - 50'h x 30'w
6. A commemorative paver comes with park trees. Please select from the following paver options:

   1. In Loving Memory of
   2. In Honor of
   3. In Celebration of
   4. Other
7. If other, please consider the below wording for consideration on the paver:
9. Name of person to be engraved on paver:
10. Tree Location Preference:
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CONDITIONS

2. Checking the box indicates that I certify that all statements and information furnished in this form are true, complete and correct to the best of my knowledge, and are made in good faith. I understand that statements or information furnished on this form are subject to verification and I agree to furnish supporting documents or information when requested.

   1. I have read and agree to the conditions.
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OFFICE USE ONLY

2. Date Approved:
3. Location:
5. Fee:
6. Date Payment Received:
8. Date Denied:
9. Reason for Denial:
11. Signature:
12. The completed form will be submitted via email for review and approval. For additional information, contact the Village of Romeoville at 815-886-7200.
Leave This Blank:


13. 1. Receive an email copy of this form.
14. Email address

    This field is not part of the form submission.

15. Submit | Go Back

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