Certificate Request

Councillor Mitchell offers congratulatory certificates for residents of Glanbrook, Rural Upper Stoney Creek and Winona  celebrating a significant anniversary, birthday or other special occasion.


Your Contact Details

Contact Person: (person requesting certificate) (required):

Mailing Address: (required)

Postal Code: (required)

Telephone: (required)

Email: (required)


Certificate Details

Name of Person/Organization on Certificate: (required)

Purpose of Certificate: (required)


Requirements

Date Certificate Needed: (required)

How would you like to receive the message? (required)


This information is being collected under the authority of Section 226 of the Municipal Act, and will be used to contact you in regards to your feedback, to keep you informed from time to time on activities in Ward 11 and the City of Hamilton, and for no other purpose. If you have any questions or concerns regarding the collection of this information, please contact Kathy Dinney in Councillor David Mitchell's Office at 905.546.4513, 71 Main Street West, Hamilton, ON, L8P 4Y5.

© Copyright 2009 David Mitchell, Ward 11 Councillor, Hamilton Ontario