Mayor's Office - Request for Certificates

Please complete the following form.  Fields marked with an asterisk(*) are mandatory.  If further assistance is required please contact Heather Welsh at 519-631-1680 ext. 4196.

Celebrant(s)' Name(s) as it will appear on the certificate
e.g. Birthday, Anniversary, Retirement, Award or Other
Date of Birth, Wedding or other occasion
Date of Celebration if different than event date
Who would you like the certificate sent to: Requestor or Celebrant
Please provide the celebrant(s) Address and Phone number
Please provide the requestor's Name, Address and Phone number
Please provide the requestor's email address
Date of Certificate Request
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