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Special Occasions Form

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Wedding Anniversary

50th

60th

65th

70th

Birthday

80th

90th

100th

Name of citizen to be honoured:

Present address:

Date of marriage/birthday:

Celebration date and time:

Celebration location:

Would you like a member of council to deliver?

Yes

No

Language preferred:

English

French

Contact Person

Name:

Address:

Telephone:

Enter a valid phone number. Example: 123-456-7890

Email:

Enter a valid email address. Example: name@company.com

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