Please complete and return this form to Editorial Services, Rideau Hall, 1 Sussex Drive, Ottawa, Ontario, K1A 0A1 or by fax to (613) 998-8760. If you have any questions, please contact Editorial Services at (613) 993-2189. Please note that we require a minimum of six weeks for the preparation and approval of messages. All publication costs are the responsibility of the requesting organization. Message requests are not accepted via e-mail.

SUPPORTING INFORMATION REQUIRED:

Individual:	a paragraph describing contributions, accomplishments, future plans, a curriculum vitae or biography.
Organization:	a historical overview, an annual report or other relevant material.
Event:	an event program or schedule and/or a detailed description of the event, its history and aims.

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OCCASION: ____________________________________________________________________

CONTACT PERSON: ___________________________________
Telephone no.: _____________

E-mail or website address:_______________________________________

TO BE:	_____ published	_____ read aloud
	_____ issued as press release or in press package	_____ other (specify)

DATE REQUIRED (indicate printing deadline, if applicable): ____________________________

LANGUAGE PREFERRED:

______ English

_____ English and French

PHOTOGRAPH OF THE GOVERNOR GENERAL REQUIRED:	______ Yes	_____ No
IF YES:	______ Colour	_____ Black and White

MESSAGE TO BE SENT TO:

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: ________________________________ Prov. __________________ P.C. ________________