REQUEST A CERTIFICATE

If someone is celebrating a special birthday or wedding anniversary, you may wish to request congratulatory greetings for the occasion.

Please provide us with at least 3 weeks notice.

What kind of certificate would you like to request? *

Date on Certificate *

Recipient Name *

First

Last

I would like Goldie to present the Certificate: *

Please provide any additional details (if necessary)

I need the Certificate by the following date: *

Certificate Delivery Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Contact Name *

First

Last

Contact Phone *

Contact Email *

Name

My Commitment To You

“I’m here to listen. I’m here to serve. Please let me know what I can do to help you, help our community, and help our province. Because your family is Ontario’s future.”

REQUEST A CERTIFICATE

My Commitment To You

GOLDIE GHAMARI • MPP