ADDRESS:

CITY:

POSTAL CODE: . TELEPHONE:

Please Enter ducks at $5.00 each
Please charge me: Visa C} Mastercard
Card No: Expiry date:

Cy My cheque for $ is enclosed’

SIGNATURE

Mail orders must be postmarked no later than March 8, 1999 “Your official Duck Number will be

recorded on the beck of your ch

The Duck Office
1044 Marine Drive
North Vancouver, B.C, V7P 1$5

980-DUCK

LOTTERY UCENSE NUMBER 779659A)