Request a Celebratory Certificate or Letter of Recognition from the Secretary of State

On the behalf of the Office of California Secretary of State Shirley N. Weber, Ph.D., we are honored to recognize California citizens who serve their community. Please complete the form below and submit at least 30 business days before the recognition is needed. Submission of this request will be reviewed and processed by the Secretary of State. Submission of this request does not guarantee that it will be fulfilled.

Type of request *

Does this recognition need to be mailed? *

Who is the best contact to return this recognition to? *

Email Address *

Phone Number *

Address (if applicable)

What date would you like this recognition completed? *

Honoree Information

Full salutation of recipient

Full salutation of recipient *

Please describe why the recipient should be honored by the California Secretary of State's Office *

You have 200 words left.

Will this recognition be displayed at an event? If so, please describe the event

You have 200 words left.

Date of the event

Organization Information

Name of organization

Mission of organization

Who does the organization serve?

You have 100 words left.

Brief biography of the recipient *

You have 500 words left.

Accolades of recipient

You have 100 words left.

Requestor Information

Requestor's full name *

Requestor's email address *

Requestor's phone number *

Request a Celebratory Certificate or Letter of Recognition from the Secretary of State

Honoree Information

Organization Information

Requestor Information

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