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Request for Certificate of Recognition
Information of person requesting the certificate:
Name
First
Last
Email
Email
Confirm Email
Mailing Information:
Please indicate who the certificate should be mailed to and the address
Mail to Address
Street Address
Address 2
City/Town
Province
- None -
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Phone
Information of the recipient of the certificate
Full Name(s) or Company/Organization Name
Please detail the reason for the certificate (i.e. 50th wedding anniversary celebration, grand opening of new local business, 80th birthday, etc.)
Date the certificate will be presented (i.e. date of birthday, anniversay, event, etc.)
May we contact you if we have any questions or concerns regarding your certificate request?:
Yes
No
Leave this field blank
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