Military Retirement Congratulatory Form

Please allow up to two weeks for your submission to be processed.

Required fields are marked with an asterisk (*)

Retiree's Information *

First name *

Last name *

Rank *

Unit

Post nominals

Years of service *

Official retirement date *

Presentation date *

Requestor's information *

First name

Last name

Email address *

Confirm email *

Phone number *

Alternate phone

Mail to:

First name *

Last name *

Unit

Address 1 *

Address 2

City/Town *

Province *

Postal code *

Additional particulars

Privacy statement In accordance with Section 485 of the Municipal Government Act (MGA), the personal information collected on this form will only be used by municipal staff and, if necessary, individuals under service contract with the municipality, for purposes relating to the processing of your recognition request.

If you have any questions about this form/survey, please call 311 or email contactus@311.halifax.ca