Birthday Greeting

Certificate Details

* Number of years Number of years... 80th 85th 90th 95th 100th 105th 110th 115th 120th

* Birth date Month... January February March April May June July August September October November December Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year...

Celebration date Month... January February March April May June July August September October November December Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year...

Language English French

Mail the certificate

to the person requesting the certificate
to the person receiving the certificate

Person Receiving the Certificate

* Recipient's name --- Mr. Mrs. Ms. Miss

* Address

* City / town ON AB BC MB NB NL NT NS NU PE PQ SK YT

* Postal code

Living Outside of Niagara Region

We do not normally issue certificates outside of Niagara region. Provide an explanation on this individual's connection to this region.

Who is Requesting the Certificate

* Your name --- Mr. Mrs. Ms. Miss

* Address

* City / town ON AB BC MB NB NL NT NS NU PE PQ SK YT

* Postal

* Telephone

* Email

Additional Information

Comments

Notice of Collection

Any personal information or personal health information submitted will be collected, used, and disclosed, where applicable, by members of Regional staff according to the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act. Any information you share will only be used for the intended purpose for which it was provided.

For questions or comments about privacy practices, or for more information about the administration of the Municipal Freedom of Information and Protection of Privacy Act in Niagara Region programs, see Freedom of Information and Open Government.