FOR TICKETS NOW Please complete and mail today... or fax to 204-813-0131
OR MAIL TO: Health Sciences Centre Foundation
PO Box 16056 CENTENNIAL PO Winnipeg, MB R3A 1M0
YES! I would like to WIN MILLIONS
PLEASE PRINT
* Name _________________________________________________________________________________
(Only one person’s name)
* Address ________________________________________________________________________________
* City________________________________________ * Province ___________________________________
* Postal Code ____________________________________ * Phone Day _________________________________
Phone Eve _____________________________________ Phone Cell___________________________________
Email ___________________________________________________________________________________
* Required fields.
PLEASE SEND ME:
HSC
MILLIONAIRE
LOTTERY
_____
_____
_____
_____
50/50 PLUS™
BIG PASSPORT
PLUS™
1 Ticket for $100
2 Tickets for $175
4 Tickets for $300
8 Tickets for $500
Total = ________________
Total = ________________
Total = ________________
_____ 1 Ticket for $15
_____ 6 Tickets for $30
_____ 20 Tickets for $60
Total = ________________
Total = ________________
_____ 1 Ticket for $20
_____ 4 Tickets for $40
TICKET
DELIVERY
METHOD
PLEASE CHOOSE ONE
Total = ________________

eTicket

Regular Mail
Total = ________________
Total = ________________
Total = ________________
TOTAL $
Tickets will be sent to the
email address provided
within 10 business days.
Tickets will be delivered
via regular mail within 3-4
weeks of ordering.
Licence LGA-1822-RF
METHOD OF PAYMENT
 Money Order  Cheque Payable to Cheques payable to HSC Foundation Lottery. Please, no post-dated cheques.

Card#
Expiry: 
_
/
18+ to Play
Signature___________________________________________________________________________
50/50 PLUS™ tickets and Big Passport Plus™ tickets must be ordered in conjunction with your 2016 HSC Millionaire Lottery tickets. Each 2016 HSC Millionaire Lottery ticket sold in a
2-Pack, or 4-Pack, or 8-Pack, each 50/50 PLUS™ Lottery ticket sold in a 6-Pack or 20-Pack and each Big Passport Plus™ ticket sold in a 4-Pack must contain the same customer information.