Employee Payroll Deduction for the 2022 Hospital Lottery

Please note this option is only available for current NBRHC employees.

Name (required)

Address (required)

City (required)

Postal Code (required)

Home Phone (required)

Work Phone (optional)

Email (required)

Fax (optional)

Please specify below if you are purchasing
this ticket for someone other than yourself
(if so please complete the fields below)

Purchase is a Gift

Recipient Name (required for Gift Purchase)

Recipient Address (required for Gift Purchase)

Recipient City (required for Gift Purchase)

Recipient Postal Code (required for Gift Purchase)

Recipient Phone Number (required for Gift Purchase)

Recipient Email (required for Gift Purchase)

I would like to receive emails of the bi-weekly winners:
I would like to sign up for the Foundation E-newsletter:
How many tickets would you like to purchase? (If more than one ticket is purchased then a Foundation staff member will contact you for further details)

*Please Note:
Payroll Deduction: I understand that I can stop this arrangement at any time with written notice to the Foundation before the 2022 draw begins on January 27th, 2022. (Payroll Deduction option is only available to NBRHC employees. Per pay deduction determined by $99 divided by number of pays remaining before the draw begins and any remaining balance will be deducted if payroll should cease for any reason).

2023 Lottery Buy Now Opportunity - Only available to NBRHC employees
(I would like $4.50 / pay deducted on a continuous basis to pre-pay for my 2023 lottery ticket beginning in January 2022. Any outstanding balance will be deducted during the last pay in 2022.)

the ticket holder is 18 years of age or older and intend to participate in the North Bay Regional Health Centre Foundation Hospital Lottery (you will need to check the box above before proceeding).

Employee Payroll Deduction for the 2022 Hospital Lottery

North Bay

Sudbury

Floor Plans