2017 PNE PRIZE HOME LOTTERY
ORDER FORM
CUSTOMER INFORMATION
Name
Address
City
Prov
Phone number
Email
BC
Postal code
Customer number, as on address label
TICKETS
PNE PRIZE HOME LOTTERY
HOW MANY SETS OF TICKETS?
TICKET TYPE
TOTAL PRICE
2 TICKETS FOR $25
$
6 TICKETS FOR $50
$
15 TICKETS FOR $100
$
50/50 PLAY (MUST BE BOUGHT IN CONJUNCTION WITH PNE PRIZE HOME LOTTERY TICKETS)
HOW MANY SETS OF TICKETS?
TICKET TYPE
TOTAL PRICE
1 TICKET FOR $10
$
5 TICKETS FOR $30
$
TOTAL AMOUNT OF ALL TICKETS: $
PAYMENT
❏ Cheque (payable to the PNE)
❏ Money order
❏ Visa
❏ MasterCard
❏ American Express
Name on credit card
Credit card number
Expiry
______ /______
CVV
Signature
Phone
❏ GIFT bought by
Email my receipt.
I’d like to receive email updates on events and promotions at the PNE.
The information provided is private and confidential and will not be sold or revealed to any third party or organization.
Please do NOT staple cheques to order form. Do NOT mail cash.
MAIL ORDERS TO: PNE Prize Home Lottery, 2901 East Hastings Street, Vancouver, BC V5K 5J1
(All cheque orders must be received by August 19, 2017)
Chances are 1 in 290,000 (total tickets for sale) to win the 50/50 prize.
Chances are 1 in 849,500 (total tickets for sale) to win a grand prize.
BC Gaming Event Licence #93961
BC Gaming Event Licence #93962
Know your limit, play within it.
Problem Gambling Help Line 1-888-795-6111
www.bcresponsiblegambling.ca
19+