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ORDER FORM<br />

FORMOLE DE COIVIMANDE<br />

To: Superintendent of Publications,<br />

Department of Public Printing and Stationery,<br />

Ottawa, Ontario, Canada.<br />

Au: Surintendant des Publications de l'Étal,<br />

Department des Impressions et de la papeterie publiques,<br />

Ottawa, Ontario, Canada.<br />

Name<br />

Nom<br />

Street Address<br />

Adresse de rue<br />

Date 19<br />

,<br />

. . •<br />

City, Zone and Province<br />

Ville, zone et province . . ,<br />

When ordering publications, please give catalogue<br />

number and title of the publication also the quantity<br />

desired and amount of the remittance.<br />

Les clients sont prlés d'Indiquer clairement, avec<br />

chaque commande, les numéros du catalogue, les<br />

titres dos publications de , même que la quantité<br />

désirée et le montant total de la remise<br />

NUMÉRO DU<br />

CATALOGUE<br />

NUMBER •<br />

QUANTITY<br />

DESIRED,<br />

QUANTITÉ<br />

TITLE OF PUBLICATION<br />

TITRE DE LA PUBLICATION<br />

. ,.AMOUNT<br />

MONTANT<br />

For additional space ; use other ski's.<br />

Voir au verso pour espace additionnel. 1Total, $<br />

Orders must be paid in advance.<br />

Les commandes sont payables d'avance.

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