Request a Certificate

MPP Natalie Pierre offers congratulatory certificates for residents in Burlington celebrating a significant anniversary, birthday or other special occasion.

To request a certificate, please complete and submit the form below.

Request Scrolls and Certificates for Special Milestones

First Name

Last Name

Street Address

Postal Code

Telephone

Name of Person/Organization

Burlington address of recipient

Purpose of Certificate

Additional Information

Date Certificate Needed

How would you like to receive the certificate?

Mail to recipients address Mail to requestor's Pick up at MPP's office

The personal information you provide is governed by the Freedom of Information and Protection of Privacy Act, and will be used to contact you regarding your feedback and to keep you informed from time to time on activities affecting residents in Burlington.

If you have any questions or concerns regarding the collection and retention of personal information, please contact us at 905-639-7924 or visit us at 306-3027 Harvester Rd, Burlington, ON L7N 3G7.