Request for Certificate (Birthdays) - Office of the Premier

On request, the Premier sends congratulatory certificates celebrating significant birthdays.

Congratulatory certificates are available for 75 years and up and in 5 year increments and then each additional year past 100. For a 100th birthday and above a certificate and letter will be issued.

To ensure on-time delivery, we ask that you submit your request at least six weeks before the event date.

Birthday

Birthday *

Date of Birthday *

Date of Celebration *

Celebrant

Title *

Mr.
Ms.
Mrs.

Name *

First

Middle

Last

Mailing Address

Address *

City / Town *

Province / Region *

Postal Code *

Requested by

Name *

First

Last

Address *

City / Town *

Province / Region *

Postal Code *

Country *

Phone *

Phone (secondary)

Email *

Delivery Instructions

Send message to: *

Celebrant
Requestor

We are collecting personal information on this form for the purpose of issuing a certificate to recognise a significant birthday or anniversary. This information is collected under the authority of section 61(c) of the Access to Information and Protection of Privacy Act, 2015. If you have any questions, please contact the Office of the Premier at 729-3570.

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