Certificate Request Form

We offer congratulatory certificates for residents celebrating a significant anniversary, birthday or other special occasion. For certain milestones, you may also request certificates from the Prime Minister, Leader of the Opposition, and the Governor General and His Majesty The King.

Information for the person submitting the request and for the celebrant(s) is required.

Requestor Information:

First Name*

Last Name*

E-mail*

Phone Number*

Address*

City*

Postal Code*

Celebrant(s) Information:

Name(s) on certificate*

Address*

City*

Postal Code*

Phone Number*

Occasion* BirthdayAnniversaryOther

If the certificate is for a birthday or anniversary, how many years are you celebrating?

Number of years:

Date of Birthday/Anniversary/Other*

How would you like to receive the certificate?

Certificate to be picked up at MP OfficeCertificate to be mailed to CelebrantCertificate to be mailed to Requestor

Please provide any further comments here, including the date the certificate is required:

Details: