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Please ensure you have read the Plaques, Monuments & Memorials Policy before completing this form.Please note: The lodgement of a request does not guarantee approval.
Details of person making the request.
Details of individual, group or organisation to be memorialised.
Please note: The location of plaques and memorials is at the discretion of the Council following consideration of masterplans, safety, traffic and pedestrian mobility, and the primary use/purpose of the location. Plaques cannot be installed in isolation or affixed to existing Council assets. Plaques can only be fixed to new assets at the discretion of the Council, in accordance with Council policies and guidelines.
Please describe the meaningful contribution(s) made to the community by the recipient.
If you have requested a plaque, please provide the following details (refer to example provided on Plaques, Monuments & Memorials webpage).
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