Delivery Form - “Happy to Chat” Bench

Donee Contact Information

Name of organization/entity/municipality:

Street Address:

City:

State:

Zip Code:

Email:

Phone:

Brief description of your organization/entity/municipality:

Delivery Details

Name of person receiving the shipment:

Street address where you would like bench(es) shipped:

City:

State:

Zip Code:

Phone of person receiving the shipment:

Number of benches to be shipped:

Do you want the bench(es) shipped immediately or at a future date:

What is the planned location for each bench and how would you describe the level of foot traffic at each location:

Design Preferences

Please note: All benches are 6 feet in length. In our experience, a lighter top color (weathered, sand, cedar or gray) with a black inlay works best to clearly see the message on the bench (benches below do not show the message).

Select bench style (each style below is shown in a specific color, but all colors are available for each style):

Style D - No Arms (shown with black base and weathered top)

Style D - With Arms (shown with black base and green top)

Style M - No Arms (shown with brown base and cedar top)

Style M - With Arms (shown with brown base and charcoal top)

Style P - No Arms (same as style D but has bullnose planks — shown in green base with sand top)

Style P - With Arms (same as style D but has bullnose planks — shown in green base with brown top)

Select bench color:

Black

Brown

Cedar

Charcoal

Green

Sand

Weathered

Select base and arm color (base and arms will be the same color):

Black

Brown

Green

Each bench comes with an attachment kit to secure it to the ground. Please choose one option below:

Securing to concrete or other hardscape Securing to raw land Not securing

Charitable Donation

The Donee accepts each bench as a charitable donation, gifted as-is, and confirms that no goods or services were given in return. Upon delivery, the bench is fully owned by the Donee, giving the Donee flexibility to place and use the bench in a way that best serves the community. With this in mind, after delivery, the Donee will be fully responsible for installation, ongoing care, public safety, and working within any local guidelines or approvals, and the Donor retains no ownership, control, or responsibility for the bench. The person signing below confirms they are authorized to accept this donation and agrees to these terms on behalf of the Donee.

Name of individual:

Title:

Date:

Additional comments you would like to share, if any: