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)