Certificate Request Form

Name
First
Middle
Last
This is how your name will appear on your Certificate. Please do not add descriptors or educational credentials.
Mailing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Please choose below how you would like to receive your certificate
If you choose to pick up, you will be contacted by email when ready.
1st floor, Registration desk
158 St. George Street.
William G. Davis Building, Room 2117A
3359 Mississauga Road.
Confirmation