Please fill out and submit the following Certificate request and my office will be in touch with you. Please note that sufficient notice is required to process all requests.

The Queen
Anniversary: 60 + or Birthday: 100 +
8 weeks notice required (copy of birth or marriage certificate required)

The Governor General
Anniversary: 50th-59th or Birthday: 90 +
6-8 weeks notice required

Prime Minister
Anniversary: 25, 30, 40, 45 & 50+ or Birthday: 75+
6 weeks notice required

MP Bonnie Crombie
Any special anniversary or birthday
6 weeks notice required

Recipient

Recipient Salutation

Mr. Mrs. Miss Ms. Dr. Councillor Commissioner Mayor Rabbi Rev.

Last Name:

Given Name:

Street Address:

Apt / Unit:

City/Town:

Province:

Select ---- AB BC MB NB NF NS NT ON PE QC SK YT

Postal Code:

Occasion

Date of Celebration (If different from above)

Requestor

Requestor Salutation

Mr. Mrs. Miss Ms. Mr. & Mrs. Mr. & Ms. Prof. Councillor Commissioner Mayor Rabbi Rev.

Last Name:

Given Name:

Street Address

Apt / Unit:

City/Town:

Province:

Select ---- AB BC MB NB NF NS NT ON PE QC SK YT

Postal Code:

Daytime Tel:

Email Address:

Where should the congratulatory messages be sent?

Last Name:

Given Name:

Street Address:

Apt / Unit:

City/Town:

Province:

Postal Code:

Daytime Tel:

Evening Tel:

Would you like to add any special message in the certificate, please write:

Please check to ensure that all fields are filled out. If any information is missing, your request cannot be processed.