Acknowledgements, memorials and monuments in public spaces

Applicant details

Given Name *

Surname *

Postal address *

Suburb *

Contact number *

Email *

Nominate a secondary contact

YesNo

Applicant details (2)

Given Name (2)

Surname (2)

Postal address (2)

Suburb (2)

Contact number (2)

Email (2)

Memorial location and details

Full name of person being memorialised *

Date of passing *

Memorial Location (e.g. Park or Road Name) *

Estimated Installation date: *

Location Description: (house number, cross street, landmark to assist Council Staff in determining desired location) *

Please select which memorial you are applying for *

MemorialMonumentTree DedicationOther (including donated assets)

Memorial

Scattering of AshesTemporary Memorial in Road ReserveTemporary Memorial in Public Space

Monument

Monument in Road ReserveMonument in Public Space

Other

For details on the Acknowledgements, Memorials and Monuments Policy please click here.

Supporting documentation

Proposed design of acknowledgement, memorial or monument *

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Aerial Map (e,g google map) showing the proposed location/site *

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Letter of support for community support (if applicable)

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Species selected for tree dedication

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Declaration

I have read and agree with the policy and guidelines and confirm that the memorialisation complies with the Acknowledgements, Memorials and Monuments Policy. *

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Date *

Cairns Regional Council is collecting your personal information for the purpose of processing your application. The collection of this information is authorised under the Local Government Act 2009. Your personal information will not be disclosed to any other person or agency unless you have given your permission or Council is required to by law.

Include all attachments as incomplete applications cannot be processed.

For further information phone Council’s Community Business team on 1300 69 22 47 or email communitybusiness@cairns.qld.gov.au