Fortune Fridays

To enroll in the Fortune Friday 50/50 Staff Lottery, complete this form and submit it to the North York General Hospital Foundation. As a participant, you are eligible to purchase up to 5 tickets for each biweekly draw during the entire lottery period of November 22, 2019 through November 20, 2020. If you are a payroll employee, each pay day, $4 will be deducted from your paycheque for each ticket. Your ticket number(s) will be valid during the entire lottery period.

Yes, I want to win. Please enroll me in North York General’s Fortune Friday.

Name:

Official Use Only: Ticket number: Charitable Registration # 88875 1245 RR 0001 | Lottery license: #11169

Department:

Address:

City:

NYGH email:

Primary phone:

Signature:

Payroll Staff: Please deduct the amount below from my bi-weekly paycheque until I notify you in writing to cancel

Non-payroll Staff and Affiliates: Please bring this completed form with a credit card (payment for a full year) to the Foundation office

Please submit your completed form to North York General Foundation by dropping it off at the Foundation office, 4001 1st floor, or emailing it to foundation@nygh.on.ca

Province: Postal code:

Employee number:

NYGH phone number:

50/50 STAFF LOTTERY

ENROLMENT FORM

Prizes: Actual prize amount varies with participation to a maximum of $7,000 per draw. Fifty percent of all money received for the biweekly draw will be awarded to the prize winner. A maximum of 3,500 tickets will be printed. Draws conducted on the Friday following each pay day. Participants must be 18 years of age or older and on North York General Hospital’s payroll. Rules and regulations are available online at NYGHFoundation.ca/staff-lottery-rules or by calling the Foundation office at 416-756-6944. Winners will be notified by phone and or email and posted online at NYGHFoundation.ca/staff-lottery. Your lottery ticket will be nullified with any missed payment. You can cancel your participation in the lottery at any time by notifying North York General Foundation in writing by email at foundation@nygh.on.ca Enrolments and cancellations must be received more than 20 days prior to the draw date. By submitting this form you are providing consent for North York General Hospital Foundation to use photographs and/or video of you as well as your name for Fortune Fridays in publications, news releases, online, and in other communications related to the promotion of Fortune Fridays.

I would like to purchase (please select 1 option): *This is not eligible for a tax receipt 1 ticket* ($4/draw) | 2 tickets* ($8/draw) | 3 tickets* ($12/draw) 4 tickets* ($16/draw) | 5 tickets* ($20/draw)

(form must be sent from an NYGH email address)