Commemorative document order form—Shipping information

Note: For new authorized service providers, the commemorative document must be prepared, mounted, framed and shipped, so a delay of up to two months is possible. All fields are required, unless specified otherwise.

1. Reason for the resquest

Reason for the request (required)

New authorized service provider (organizations that have never received a Measurement Canada commemorative document)

Replace existing commemorative document (indicate below why a replacement is being requested)

Other (specify below)

Additional information (Optional)

2. Shipping information

Organization name (required)

Accreditation or registration number (AXXXX or RXXXX) (required)

Management representative name (required)

Management representative email address (required)

Shipping address (required)

Telephone number (Optional) (999-999-9999)

Comments (Optional)

Language selection

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Commemorative document order form—Shipping information

1. Reason for the resquest

2. Shipping information