Please complete and return this form to Editorial Services, Rideau Hall, 1 Sussex Drive, Ottawa, Ontario, K1A 0A1 or by fax to (613) 998-8760. If you have any questions, please contact Editorial Services at (613) 993-2189. Please note that we require a minimum of six weeks for the preparation and approval of messages. All publication costs are the responsibility of the requesting organization. Message requests are not accepted via e-mail.

SUPPORTING INFORMATION REQUIRED:

Individual:	a paragraph describing contributions, accomplishments, future plans, a curriculum vitae or biography.
Organization:	a historical overview, an annual report or other relevant material.
Event:	an event program or schedule and/or a detailed description of the event, its history and aims. These messages cannot be altered without the specific approval of the Office of the Secretary to the Governor General. In addition, programs with a message from the Governor General cannot be sold.

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OCCASION: ____________________________________________________________________

CONTACT PERSON: ___________________________________
Telephone no.: _____________

E-mail or website address:_______________________________________

TO BE:	_____ published	_____ read aloud
	_____ issued as press release or in press package	_____ other (specify)

DATE REQUIRED (indicate printing deadline, if applicable): ____________________________

LANGUAGE PREFERRED:

______ English

_____ English and French

PHOTOGRAPH OF THE GOVERNOR GENERAL REQUIRED:

______ Yes

_____ No

MESSAGE TO BE SENT TO:

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: ________________________________ Prov. __________________ P.C. ________________

If you have already submitted your request for a message, please do not send additional copies of the same via fax, e-mail or regular mail.