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Mail to:
Ron Beaupre
P.O. BOX 3190
Morrisburg, On. KOC 1XO
Captain Robert Hull
P.O. BOX 81, Wiarton, On. N0H 2T0



Cheques made payable to ISMA Lodge 15
Please send self addressed envelope with your cheque. If Canadian include stamp.

Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________


Phone: (___)___________

Amount Enclosed: ___________ tickets are $5.00 (Canadian) each

Number of tickets: ______

Your ticket(s) will be promptly mailed to you.
Drawing to be held on February 23, 2013.
Winner need not be present at drawing to win.

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