Request an Anniversary Message

This form is for residents in the Herbert electorate to request anniversary messages from the Queen, the Governor-General and/or the Prime Minister. For further information visit the official information page.

Your name*
Title First Last
Email*
Mobile Phone
Type of message being requested*
Name of person celebrating birthday/anniversary*
Title First Last
Preferred name, if different from above
Name of spouse, if requesting anniversary message
Title First Last
Preferred name, if different from above
Address
Address Suburb State Post Code
Postal address if different from above
Address Suburb State Post Code
This is where the message will be posted
Birthday/anniversary number*
E.g. 100th birthday, 60th anniversary
Date of birthday/anniversary*
DD
MM
YYYY
Date message should arrive*
DD
MM
YYYY
Messages can be posted a maximum of one month prior to the occasion
Supporting documentation*
Drop files here or
Copies of birth certificates, passports or marriage certificates, or a statutory declaration. Maximum file size 2MB.
Comments
This field is for validation purposes and should be left unchanged.

Request an Anniversary Message

Request an Anniversary Message

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