Certificate Request Form - Municipality of Chatham-Kent

Upon request, the Mayor will provide a certificate to recognize special milestones being celebrated by Chatham-Kent residents.

* Indicates a mandatory field

Contact Person / Person Making the Request

Name *

Telephone *

Email *

Date Required *

Name of Person / Organization to be honoured *

Occasion Being Celebrated *

Birthday

Specify a year

Anniversary

Specify a year

Achievement

Specify achievement

Date of Occasion *

Pickup Options *

To be be picked up - Specify a location

To be mailed to the person making the request - Specify name below

To be mailed to the person(s) receiving the certificate - Specify name below

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Having issues? Contact us by e-mail, or our call center at 519-360-1998 (regular business hours are Monday to Friday, 8:30 AM to 4:30 PM)