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Send a Self-Addressed Stamped Envelope To:
Lt. Ron O’Donoughue
Rr 1, Owen Sound, On
Canada, N4k 5n3

The tickets are $10.00 each.
Make checks payable to: ISMA Huronia Lodge #15

Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________


Phone: (_____)_________________

Amount Enclosed: ___________ tickets are $10.00 each

Number of tickets: ______

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