Certificate Request

Please read the following criteria before completing the certificate request form below.

Certificates are provided as a courtesy and issued by Chairwoman Nora Vargas, Supervisor of San Diego County’s First District, to recognize and honor individuals and groups for their contributions to San Diego County, and in celebration of milestone occasions.

Certificate request must be made at least two weeks prior to the date needed.

Certificates can be issued for the following:

Individual (milestone, significant birthday, accomplishment)
Organization/Group (special event, conference, milestone)

The Supervisor’s office reserves the right to modify or decline any certificate request.

Certificate Information

Subject

Date the Certificate is requested for

Recipient Type

Recipient Name

Information about the honoree

Please provide suggested language that you’d like to be included in the actual document

Presentation Information

Would you like for Supervisor Vargas’ staff to present at an event? Yes No

Event Details

Name of Organization

Event Date

Event Time

Venue Name

Venue Address

How many attendees are you expecting?

Event Description

Will Media be invited? Yes No

Please provide any other relevant information

Contact Information

Name of Requester

Affiliation to Recipient

Organization

Phone Number

Zip Code

Contact Us

County Administration Center
1600 Pacific Highway, Rm 335
San Diego, CA, 92101

Phone:
619.531.5511

Email:
District1community@sdcounty.ca.gov

NORA VARGAS

Certificate Request

Contact Us

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