Chapter, District, or Region requesting the certificate
Description and date of the event Is this a one time event
Location and Address of the event (include name of building)
Do you have a contract agreement with the venue for the event?
How many people will be in attendance?
Name of Person requesting the certificate
Office Held
Mailing Address
City
State/Province == choose one == ==USA== AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MR MS MT NC ND NE NH NJ NM NN NV NY OH OK OR PA PL PO PR RI SC SD TN TT TX UT VA VI VT WA WI WV WY ==Canada== AB BC MB NB NL NS NT NU ON PE QC SK YT ==International==
Phone Number
Fax
Email Address
If necessary, please include additional remarks such as: additional insured, any specific verbiage needed, or endorsement. If you have questions or need assistance, send an email to info@nats.org or call 904.992.9101.
