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Tonka Bay Donation Program <br />rr <br />V ;1a'�+ <br />Applicant Information <br />Donor Name <br />Address <br />City, State ZIP <br />Daytime Phone <br />Email <br />Donation Information <br />Donation Type <br />Desired Location (park name or street address and describe the location within the park) <br />Donation Amount (please see program for current donation levels) <br />Proposed Plaque Text (reviewed for appropriateness to policy and subject to approval) <br />I have read, fully understand, and agree to abide by the attached Donation Program Policy <br />Signature of Donor <br />Date <br />Please complete and return this form and your check for the total amount (payable to "City of <br />Tonka Bav") to: City of Tonka Bay, 4901 Manitou Road, Tonka Bay, MN 55331. <br />If you have anv questions please contact us at 952.474.7994. <br />