246 Stavanger Drive, St. John’s OPEN HOUSE 12-9 DAILY GRAND PRIZE OPEN HOUSE 12-9 DAILY 246 Stavanger Drive, St. John’s 2nd Prize: KIA Soul LX or 18,000.00 .00 cash 3rd Prize:: $15,000 New York Shopping Spree ee Ultimate 50/50 EXTRA COSTCO Available online, by order form or by phone. 4th P Prize i tto o 30th Prize: Pi $250 Ultramar Gift Cardss Last Years' Jackpot was over $196,000.00... What will it be this year? Total value of prizes to be given away $706,950 Last Day To purchase: Tues, Jan. 6, 2015, Draw Date: Wed., Jan. 28, 2015 Licence No: 14-10255900LT, # of tickets printed: 84,500 Come for a tour Follow us www.ultimatedreamhomelottery.com THANKS TO OUR SPONSORS Official Ultimate Dreamhome Lottery Ticket Request Form (Official ticket will follow in approximately 2 weeks) Ticket order forms sent by mail must be postmarked by our ticket sales cut-off date of Jan. 6, 2015. Please mail to 1081 Topsail Road, Mt. Pearl, NL A1N 5G1 or send by fax to 709-753-5640. Also online at www.ultimatedreamhomelottery.com. Or by phone: locally 709-738-2946, provincially 1-866-403-7326, or contact our office at 709-753-3224 for a sales location near you. Name: Address: All proceeds from the Ultimate Dreamhone Lottery are used to support CHHA-NL programs and services in this province Do you, or someone you know, have hearing loss? Would you like to know more about hearing loss or what is available to assist you? City/Town: Province: Day Phone: Evening: Email address: Ticket sales are intended for residents Newfoundland and Labrador. Purchaser must be 18 years or older. Please send me Ultimate Dreamhome Lottery ticket(s) for $25.00 each. Please add the following Ultimate 50/50 extra options to my ticket(s). Please choose one option per ticket requested. The Canadian Hard of Hearing Association - Newfoundland and Labrador (CHHA-NL) is the place to call Ultimate 50/50 Extra tickets at $10 each or set(s) of 3 Ultimate 50/50 Extra tickets for $25 a set set(s) of 5 Ultimate 50/50 Extra tickets for $40 a set Our Programs and Services Include: • Information Services • Hearing Awareness Training • Assistive Technology Loans Program • Adopt-a-Daycare Program • Resource Library • School & Public Presentations • Free Newsletters • Hearing Accessibility • Membership Postal code: • Summer Camp • Resource Groups - Youth - Meniere’s/Tinnitus - Families - Cochlear Implant • LEAP ( Leadership, Empowerment, Achievement, Program) No thank you, I do not wish to participate in Ultimate 50/50 Please note each ticket in a set must contain the same information. If ticket(s) will be sent as gifts(s) please provide the name(s) for each Ultimate Dreamhome Lottery ticket and corresponding set of Ultimate 50/50 Extra Tickets. Name Name Name Total amount of payment: Thanks to your support, all of our programs are FREE of charge! For more information visit our website at www.chha.nl.ca Donations Gratefully Accepted ❒ Visa ❒ MasterCard ❒ Cheque/Money order (make payable to CHHA-NL, no post-dated cheques please) ________/_________/_________/________ exp: ____/_______ Signature: * Cash/Debit are available at Avalon Mall,Village Shopping Center, The Ultimate Dream Home and CHHA-NL office only OFFICE USE Follow us Date Submitted Order Taken by Order ID#