Request Certificates

Requesting From:

Check the Appropriate Individual(s)
Hon. Justin Trudeau Leader of the Liberal Party of Canada		Hon. Stephen Harper Prime Minister of Canada Birthdays (75+) Wedding Anniversaries (50+)
Mr. Dwight Ball Leader of the Liberal Party of Newfoundland and Labrador		His Excellency the Right Honourable David Johnston Governor General of Canada Birthdays (90+) Wedding Anniversaries (50+)
Hon. Kathy Dunderdale Premier of Newfoundland and Labrador		Her Majesty Queen Elizabeth II Birthdays (100+, 5 yr intervals) Wedding Anniversaries (60+)
Hon. John Crosbie Lieutenant Governor Birthdays (80+, 5 yr intervals) Wedding Anniversaries (50+)

Type of Certificate:

Certificate:	-- Select a Certificate -- Birthday Anniversary Other
Years / Age:

Name of Celebrant:

First Name:
Last Name:

Address of Celebrant:

P.O. Box:
Street:
City:
Province:	-- Select a Province -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code:

Actual Date of Occasion:

Date:

e.g. mm/dd/yyyy

Date of Event Celebration:

Date:

e.g. mm/dd/yyyy

Send To:

Same as Address of Celebrant:
First Name:
Last Name:
P.O. Box:
Street:
City:
Province:	-- Select a Province -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code:

Your Contact Information:

Email:

e.g. me@domain-name.com