Required fields are marked with asterisks (*)

Welcome

Please complete the form below to submit a Certificate request from the Mayor.

Certificate Request Type

Birthday

Wedding Anniversary

Date of Birthday/Anniversary being celebrated

Please provide the name (first and last) of the individual(s) being celebrated

Are there any other special notes or relevant information you would like to include?

How would you like to receive the certificate?

Presented in person by the Mayor (dependent on the Mayor's availability)

Pickup in Person

What date do you need the Certificate ready by?

Contact Information

Please provide your contact information

First and Last Name

Email Address

Phone Number

Street Address (e.g., 123 Main Street)

City/Town

Postal Code

Notice of Collection

This form may contain personal information as defined under the Municipal Freedom of Information and Protection of Privacy Act. This information is collected under the legal authority of the Municipal Act, 2001, S.O. 2001 c25, as amended. This information will be used and maintained by the Municipality of Lambton Shores for administering the Municipal Certificate from the Mayor request process. Questions regarding this collection may be directed to the Municipal Clerk.