FOR TICKETS NOW FAX TO 204-231-0041
OR MAIL TO: ST. BONIFACE HOSPITAL & RESEARCH FDN
YES!
PO Box 73 - STN Norwood Grove 208 Provencher Blvd Winnipeg, MB R2H 3B8
2017 LOTTERY
PLEASE PRINT
I would like to
WIN MILLIONS
* Name ____________________________________________________________________
(Only one person’s name)
* Address ___________________________________________________________________
* City_________________________________ * Province ____________________________
* Postal Code _____________________________ * Phone (Day) __________________________
Phone (Eve) _____________________________ Phone (Cell)____________________________
Email ______________________________________________________________________
* Required fields.
PLEASE SEND ME:
TICKET DELIVERY METHOD
Please Choose One
eTicket
Tickets will be sent to the email address
provided within 10 business days.
Regular Mail
Tickets will be delivered via regular mail
within 3-4 weeks of ordering.
2017 MEGA MILLION CHOICES LOTTERY
_____ 1 Ticket for $100
Total =
_____ 2 Tickets for $175
Total =
_____ 4 Tickets for $300
Total =
_____ 8 Tickets for $500
Total =
________________
________________
________________
________________
18+ to Play
Yes
Would you like to be contacted about how you can
further impact critical care at St. Boniface Hospital?
50/50 PLUS™ tickets and BIG SCORE PLUS™ tickets
must be ordered in conjunction with your 2017
Mega Million Choices Lottery tickets.
Allow 3 to 4 weeks from the date of the order for receipt
of your official ticket numbers. Each 2017 Mega Million
Choices Lottery ticket sold in a 2-Pack, 4-Pack or 8-Pack,
each 50/50 PLUS™ Lottery ticket sold in a 6-Pack or 20Pack and each BIG SCORE PLUS™ ticket sold in a 4-Pack
or 8-Pack must contain the same customer information.
ADD ON - 50/50 PLUS™ Must order Main Lottery tickets
_____ 1 Ticket for $15
Total = ________________
_____ 6 Tickets for $30
Total = ________________
_____ 20 Tickets for $60
Total = ________________
BIG SCORE PLUS™ Must order Main Lottery tickets
_____ 1 Ticket for $20
Total = ________________
_____ 4 Tickets for $40
Total = ________________
_____ 8 Tickets for $60
Total = ________________
TOTAL $
METHOD OF PAYMENT
Cheque Payable to St. Boniface Hospital Foundation. Please, no post-dated cheques.
Card#
Expiry: _
/
License No. LGA1517RF
Signature________________________________________________________________