Twelfth District Certificate Request Guidelines
Please read the criteria below before submitting the certificate request form.

- Certificates are provided as a courtesy and issued by Los Angeles City Councilmember John Lee to recognize and honor individuals for their contributions to the Twelfth Council District and the City of Los Angeles.

- Certificates are issued to recognize milestone occasions of exceptional significance.

- Certificates are only issued to current Twelfth District residents or organizations within the District.

- One certificate will be provided per organization or individual per year.

- The honoree must have made a significant contribution to the Twelfth District or the City of Los Angeles.

- You may not request a certificate for yourself.

- The Councilmember's office reserves the right to rescind a certificate if false or misleading information was provided in the application.

- The Councilmember’s office reserves the right to decline any certificate request.

*Please Note:
Certificate requests must be submitted 3 WEEKS PRIOR to the date needed.  Requests will be reviewed and the requester will be notified of approval or denial in a timely manner. Due to the high volume of requests, the Councilmember’s office may not be able to accommodate your request even if the criteria outlined above are met.
Sign in to Google to save your progress. Learn more
Would you like to proceed to the Certificate Request Form? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of City of Los Angeles. Report Abuse