NLS/BPH: Administrative Documents, Volunteer Recognition Certificate Order Form

NLS can provide certificates to honor library and machine-repair volunteers. They feature the Library of Congress seal, are personalized with the volunteer's name, sponsoring group's name (where appropriate) and are signed by the director of NLS.

Allow one month lead time for fulfilling a request.
You may cut and paste from other documents the names of volunteers; this form enables you to request multiple certificates.
Use the special instructions area as needed.
Call the NLS Publications and Media Section at 1-800-424-8567, if you have questions or special requirements.

Person Requesting Certificate

Name

Phone Number

E-mail Address

Library or MLA name

Delivery Address

Address Line 1

Address Line 2

City State ZIP Code

Date certificates are needed.

Library Volunteers

Enter the names exactly as they will appear on the certificate.

Machine-Repair Volunteers

Enter names exactly as you wish them to appear on the certificate.

Sponsoring group name, if applicable.

Special Instructions

In this area enter any special instructions for this request.

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Network Documents

Volunteer Certificates