Application for a Memorial Tree

The Town of Bassendean facilitates the placement of memorial trees, as per the Purchase and Placement of Memorial Seats and Trees Policy. Please note that tree plantings generally have a 50%-80% survival probability over 35 years. The facilitation and implementation of the tree memorial is subject to the following:

A Memorial Tree Application form will need to completed to request the planting of a tree.
Tree planting locations will be provided for the planting season. The resident can request to plant a tree in a specific park, however, the preferred location may not always be possible.
The planting of the tree is to be undertaken by the Town on a date/ time agreed with by the applicant, with optional assistance from the applicant.
Planting of trees will be carried out during the winter planting season.
The tree will be managed with the same care and protection of general street and reserve trees located in the Town.
Memorial plaques or other materials will not be left on or near the tree.

The cost of a Memorial Tree as per the 2026/27 Annual Fees and Charges is $465 including GST.

Applicant Details

Full name of applicant:*

Address:

Street Address:*

City:*

State:*

Post Code:*

Country:*

Contact phone number:*

Contact email:*

Individual Details

Name of person being commemorated:*

Date of passing:*

Relationship to applicant:*

Any information you'd like to share about the individual: (optional)

Memorial Tree Details

Preferred location:*

Preferred tree species:*

Key dates requested for planting: (noting must be within the winter months of May- September)*

Acceptance*

I hereby state that I have read, understood, and agree to the above conditions and that all information provided in this Application Form is true and accurate.

Privacy and Responsible Information Sharing

The personal information collected on this form will be used by the Town of Bassendean to manage and administer its services and meet legal and governance obligations. Your information may be disclosed to relevant third parties where necessary to provide these services or where required or permitted by law.

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