Forms & Applications

Certificate Request Form

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Certificate Request Form (Policy CO12.1)

Policy Statement: The Corporation of the Town of South Bruce Peninsula desires to be a part of important commemorations and celebrations which honour individuals, groups, businesses, and other organizations within the Town. Procedure: Congratulatory certificates are available for: • Anniversaries • Birthdays • Milestone Occasions • Official Openings • Outstanding Community Events • Special Honours Individuals and organizations wishing to obtain a congratulatory certificate must first submit a formal request to the Clerk's Department through the form below. All requests will be reviewed by a staff member who will contact you if further information is required. Please note that requests should be submitted a minimum of two weeks in advance of the print deadline. Requests with incomplete or missing information will not be considered. In the event that you wish to have the certificate formally presented by the Mayor or a member of Council please contact the Clerk's Department directly at least three weeks prior to the event date. While we cannot guarantee that someone will be available every effort will be made to ensure that the Mayor or an alternate are available at your function to make the presentation.

What is your name?*

What is your address?*

Street Address Address Line 2 City Province Postal Code

What is your telephone number?*

What is your relationship to the recipient?

Please provide the recipient's name? (This will appear on the certificate)*

What is the occasion?*

What is the date for the event?*

What is the recipient's address?

Street Address Address Line 2 City Province Postal Code

What is the recipient's telephone number?*

How would you like to receive the certificate?*

Certificate Request Form

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