Congratulatory Certificate Request

Please choose the Certificate Request type:
Birthday:

Birthday: 75 years 80 years 90 years 100 years Other Other
Date of Birth: Date of Birth: / MM / DD YYYY
Anniversary:

Anniversary: 25 years 50 years 60 years Other Other
Date of Anniversary: Date of Anniversary: / MM / DD YYYY
Special Notes: (brief history of the resident(s), surprise event, details, long time resident, etc.)
Celebrant Name(s): (as it will appear on the certificate. PLEASE VERIFY SPELLING)
Celebrant Address: Celebrant Address:
Street Address City Province Postal Code
Requesters Name:
Requesters Email:
Requesters Address: Requesters Address:
Street Address City Province Postal Code
Will you be picking up the certificate or would you like it mailed out?
Where would you like it mailed out to?
Would you like the certificate to be presented by the Mayor (or designate) at your event if available?
Date of Event: Date of Event: / MM / DD YYYY
Location of Event:
Time of Event: Time of Event: : HH MM AM/PM
Please note that we require 4-6 weeks for preparation of your certificate.
Contact Info:
Office of the Mayor
100 Dissette St., Unit 4
PO Box 100
Bradford, ON, L3Z2A7
905-775-5366 ext. 1200
kgill@townofbwg.com

All personal information on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, 2001 and will be used for the purposes of the Congratulatory Certificate Request form. Questions regarding this collection may be directed to the Clerk, 905-775-5366, 100 Dissette Street, Unit 7 and 8, Bradford, ON L3Z 2A7.

Congratulatory Certificate Request

Please note that we require 4-6 weeks for preparation of your certificate. Contact Info: Office of the Mayor 100 Dissette St., Unit 4 PO Box 100 Bradford, ON, L3Z2A7 905-775-5366 ext. 1200 kgill@townofbwg.com

Please note that we require 4-6 weeks for preparation of your certificate.
Contact Info:
Office of the Mayor
100 Dissette St., Unit 4
PO Box 100
Bradford, ON, L3Z2A7
905-775-5366 ext. 1200
kgill@townofbwg.com