Long Service Certificate Request

Chairman: Judy Bates, jlbates5900@sbcglobal.net

Certificates for Club Anniversaries or Long Term Member Service (defined as 20+ years) may be obtained from your CGCI Certificates Chairman.

Complete and submit the form below.  It will automatically be sent to the Chairman
Please allow 4 weeks for processing, shipping and handling

Club or District requesting certificate
Person submitting request
PRINT FORM (If you need a copy for your records, print before clicking on Submit)