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Special Occasion Certificate Request

Special occasion certificates are issued to Loyalist Township residents to recognize the following significant events:

Please double check your responses to ensure contact details are listed and spelt correctly.

If you have troubles filling out the form please contact the Clerk's Department:

Clerk's Department
clerks@loyalist.ca
613-386-7351 ext. 100#

Please select the occasion celebrated:

Birthday

Anniversary

Graduation

Retirement

First name(s) of recipient(s)

Last name(s) of recipient(s)

Please provide brief details regarding the milestone being celebrated.

Date of milestone (i.e. year of marriage or birth) - MM/DD/YYYY