Certificate Request Form

To request a certificate, please complete the form below.  Complete as much information as your can to help us track down your certificate.

Please note that there is a processing fee of $15.00 plus HST for re-issuing a certificate.  This fee must be paid before the certificate is issued.

[contact-form to=’admin@easternsafety.ca’ subject=’Certificate Request – ESS Web’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Course Taken’ type=’text’ required=’1’/][contact-field label=’Course Location’ type=’text’ required=’1’/][contact-field label=’Approx Date of Course’ type=’text’/][contact-field label=’Company’ type=’text’/][contact-field label=’Email’ type=’email’/][contact-field label=’Phone Number’ type=’text’/][contact-field label=’Any Additional Comment’ type=’textarea’/][/contact-form]

Once submitted you should receive a response within 2-4 business days.