City of Peterborough

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Commemorative Certificate Request Form

For a special occasion, the Office of the Mayor is happy to provide a commemorative certificate. This can include:

Significant birthdays or anniversaries
Important family, community or organization milestones
Special events

Who is the Certificate for?

Last name

First name

Address

City

Province

Postal code

Name as it should appear on the certificate

Add another person Remove

Date of upcoming occasion

Number of years

Address

City

Province

Postal code

Your Information

Provide your contact information in case we need to contact you.

First name

Last name

Phone number

Email address

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