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.<br />

ORDER FORM<br />

To: Superintendent of Publications,<br />

Department of Public Printing and Stationery,<br />

Ottawa, Ontario, Canada.<br />

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

FORMULE DE COMMANDE • Département des impressions et de la papeterie publiques,<br />

, Ottawa, Ontario, Canada,<br />

r<br />

Name<br />

Nom<br />

Street Address<br />

Adresse de rue<br />

I City, Zone and Province ' - ' " ,<br />

Date 19<br />

. . .<br />

. ,.. .. .<br />

, Ville, zone et province . ' •<br />

, .<br />

.<br />

. . . . . .<br />

; ' When ordering publications, please give catalogue Les clients sent priés d'indiquer clairement, aye:<br />

I number and title of the publication also the quantity cheque, commande, les numéros du catalogue, 41<br />

desired and amount of the remittance. . . , ... , . titres des publications de marne que la quantli f<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 specs use other side.<br />

•<br />

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

Orders must be paid in advance.<br />

Les commandes sont payables d'avance.

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