Tree Preservation Order Nomination Form

Applicant Details

Name*

Address*

Suburb*

State*

Postcode*

Contact Number*

Email Address*

Tree Details

Address/location of tree*

Common name and/or botanical name of tree (if known)

Number of trees nominated*

Reason for Nominating Tree

Please select:

Aesthetic Quality
Historical Association
Rarity
Other Significance

Please describe why you consider the tree has special significance to the community of the Town of Bassendean, and why it should be considered for a Tree Preservation Order:*

Please upload at least one document

Photo(s) of the tree(s)

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

What is the condition of the tree?*

Good
Fair
Poor

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