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2. Memorial and Tribute Gifts Form

   Thank you for your interest in donating a memorial or tribute gift to the City of Ankeny. Please fill out this form and a staff member will be in touch soon to discuss your gift. 

4. First Name*
5. Last Name*
6. Email Address*
8. Address*
9. Phone Number*
11. City*
12. State*
13. Zip Code*
15. I am interested in donating money for the following

    1. Sports Balls $250
    2. Tree $500
    3. Picnic Table $1,200
    4. Bench $1,200
17. The donation of a bench or picnic table includes a plaque installed on the item with an inscription. What is your preference?
19. Donated by
21. In loving memory of
23. Other
25. Do you have any questions?
27. Thank you for interest in donating a memorial or tribute gift to the City of Ankeny.

    A staff member will be in touch soon.

    If you have questions, please contact Ryan Harkema, Parks and Recreation at 515-963-3570.

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field