Clone of Leadership 1

Please complete the following details.

Your request may be processed 2-3 weeks from sumbission date to allow for record/history search.

First Name

Last Name

Email Address

Former Name(s) (if you have a different name associated with your CPD records)

First NameLast Name

Select your item(s) below:

Address (if you require a mailed certificate)

Street Address

Street Address Line 2

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Please list the Course(s) / Program(s) here.

Please specify what you require in your letter here. (Ie: Grades, Contact Hours, etc.)

Please upload your Verification form from the third-party.

Payment Information

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Confirmation of Completion Letter

$25.00 CAD

Verification of Completion Form

$25.00 CAD

Replace Lost Certificate

Hard Copy Mailed Version Only

$25.00 CAD

Enter coupon

Subtotal

Tax

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Total Amount Paid

Applicable taxes (13% HST) will be added to the registration fees.

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