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ORDER FORM<br />

FORMULE DE COMMANDE<br />

To: Superintendent of Publications,<br />

Department of Public Printing and Stationery,<br />

Ottawa, Ontario, Canada.<br />

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

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

Ottawa, Ontario, Canada.<br />

Date 19<br />

Name<br />

Nom<br />

Street Address<br />

Adresse de rue<br />

City, Zone and Province<br />

Ville, zone et province<br />

•<br />

When ordering publications, please give catalogue<br />

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

desired and amount of the remittance. .<br />

HUMÉRO DU<br />

CATALOGUE<br />

NUMBER<br />

QUANTITY<br />

DESIRED<br />

QUANTITÉ<br />

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

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

titres des publications de mémo que la quantité<br />

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

„ .<br />

TITLE OF PUBLICATION<br />

TITRE DE LA PUBLICATION<br />

AMOUNT<br />

MONTANT<br />

For additional space use other side.<br />

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

Orders must be paid in advenue. •<br />

Les commandes sont payables d'avance.

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