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  Mail to:
Lodge 20 Raffle

Mr. Jerry Bissette

63 MacDonald Ave.

Thorold, Ontario

L2V 3E5  

 To enter please send a cheque or money order payable to ISMA Lodge 20 in a stamped self-addressed envelope.

Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________

Country:______________

Phone: (___)___________

Number of tickets: ___________ tickets are $5.00 (Canadian) each

Amount Enclosed: ___________

Drawing February 18th, 2006


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