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Certificate Request
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Email
Name of Requesting Organization
Name of Requester
Contact Phone
Name of Event
Date/ Time of Event
Date/ Time of Event: Date
Date/ Time of Event: Time
Request Senator to Present Certificate
Name of Recipient
First Name
Last Name
For single certificate request, please input name information above.
Upload a File
If you are requesting more than one certificate, please upload a Microsoft Excel spreadsheet (xlsx). For less than 10 certificates, please submit this form 3 business days prior to the date needed. Please enter the first and last name(s) of the awardee(s). If greater than 10 certificates, please submit this form 5 business days prior to the date needed. For an example format, click here.
One file only.
200 MB limit.
Allowed types: xls, xlsx, google, sheet.
Honor/Award Title
Type of recognition/ description of honor ( Example: "Teacher of the year", "Student of the Month", "Chamber of Commerce ribbon cutting", "Veteran of the Year").
Honoree Information
Describe the activity done by this honoree.
Event Information
Provide Date, Time, Location of event along with any details regarding the event.
Expected # of Attendees
Additional Information
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Certificate Request