Request a Certificate from the Mayor

Please note: The fields marked * are mandatory.
Requestors First Name*
Requestors Last Name*
Requestors Address
Requestors City/Postal Code*
Requestors Phone*
Requestors Email*
Recipient First Name*
Recipient Last Name
Recipient Address*
Recipient City/Postal Code*
Occasion*
Date of Birthday / Anniversary
Date of Celebration
Age / Year being celebrated*
How would you like to receive the certificate?*
Invite your local councillor?*

If yes, what is the name of local councillor?
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Privacy Statement

​The personal information on this form is collected under the authority of the Municipal Act S.O. 2001, c.25. This information will be used to assist with processing a request and/or to address a concern communicated to Mayor Jeffrey.  Questions about the collection of this personal information should be directed to Elvira Meitz, Assistant to the Mayor’s Chief of Staff, at 905-874-2000 ext. 42600.