Anniversary Certificate Order Form

Anniversary Certificate Request Form
The purpose of the Anniversary Membership Certificate is to mark a member’s milestone anniversary years

Requirements for this award are that the member must have achieved either 25, 50, or 75 years of membership.

Recipients receive a printed certificate acknowledging the member’s specific 25th, 50th, or 75th anniversary of their initiation and the chapter.

The cost is $5.00 each plus shipping.

No nominations are required for this award.

Certificates are available upon the member achieving their respective anniversary date. They are traditionally presented at Founders Day events or at other appropriate times by a Chapter Collegiate or Alumni Association. However, any member may request an anniversary certificate.

Please Note: Anniversary Certificate Requests must be submitted no later than ten days in advance to allow for processing.

If you have any questions about the anniversary certificate program, please email at awards@sae.net

Tell us about the certificate.
Certificate Type*
Certificate Presentation Date*

MonthDayYear
Date
Presented on behalf of a(n)..*
Staff Pin*
Tell us about the member.
Member Name*
As you wish it to appear on the certificate
Chapter and/or School of initiation*
Initiated Date of MEMBER

MonthDayYear
Date

INITIATED DATE CALC
Today's Date

MonthDayYear
Date
Date Calculation
Month Full
Day Full
Year Full
Tell us about yourself
Name of Nominator*
First and Last
Nominator Email Address*
Nominator Phone Number*

Anniversary Certificate Mockup

Please review all details before proceeding.
Anniversary Certificates will print with information as it appears below.
If you would like to make any edits, visit the previous page and change any spelling mistakes.

Approve Certificate Mockup*

I approve of the Anniversary Certificate as displayed above, and approve to print the information as previewed.

Shipping and Purchase Details
Shipping Method*
Order Number*
Included in e-mail receipt
Would you like to add on a Certificate Holder?*
Available upon request
Shipping Address for Certificate*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Certificate Cost
Shipping Fee
Certificate Holder Cost
Total
Order Number UID
Order Number Mask
Should be Empty:

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Anniversary Certificate Request Form

Tell us about the certificate.

Tell us about the member.

Anniversary Certificate Mockup

Shipping and Purchase Details