Please arrange to have a tree planted in memory of...

Name of Deceased:

Date of Death:

From...

Name(s) of donor:

The tax receipt should be provided to...

Name:

Address:

Phone:

Please send notification of this tree planting to (family member of the deceased):

Name:

Address:

I have enclosed a cheque in the amount of $30.00 payable to St. Clair Region Conservation Foundation.

Mail to:
McKenzie & Blundy Funeral Home & Cremation Centre
431 North Christina St.
Sarnia, ON N7T 5V8