Requester Information
First Name*
Last Name*
Phone*
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-
Email*
Recipient Information
Is the scroll being requested for an individual or organization?*
Select One
Individual
Organization
Organization Name*
First Name*
Last Name*
Occasion Type*
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Contributions to the local community
Birthday
Wedding Anniversary
Organization Anniversary
Business Anniversary
Retirement
Occasion Date*
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-
Birthday Years*
Select One
80
85
90
95
100
105
Wedding Anniversary Years*
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40
50
60
70
80
Organization Anniversary Years*
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10
15
20
25
30
35
40
45
50
Business Anniversary Years*
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10
20
30
40
50
Years of Service*
Key Messages to Include*
Please be as detailed as possible
Would you like the Mayor to Co-Sign the Scroll?*
A
Yes
B
No
How would you like to receive the scroll?*
A
Presented In-Person
B
Picked up
C
Mailed
This option is subject to my availability. Please fill out the Event Invitation Form:
https://www.chrismoise.ca/eventinvite
You will receive an email once your scroll is ready for pickup at Toronto City Hall (100 Queen Street West).
Street Address*
Unit/Suite #*
City*
Province*
Postal Code
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