Complete Your Canco Prize Card Here!
First Name:
Last Name:
Age:
E-mail:
Phone:
Address:
City:
Province/State:
Postal Code:
Country:
Canada
United States
Date of Purchase:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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26
27
28
29
30
31
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2006
2007
Number of Canco Prize Card:
(i.e. 1,2,3,...)
Please keep your original receipt of purchase; you may need it to claim your prize!
By submitting this form you agree with
Canco Draw Rules
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