Signature Name/Address
1. ____________________________________________________________________
2. ____________________________________________________________________
3. ____________________________________________________________________
4. ____________________________________________________________________
5. ____________________________________________________________________
6. ____________________________________________________________________
7. ____________________________________________________________________
8. ____________________________________________________________________
9. ____________________________________________________________________
10. ___________________________________________________________________
11. ___________________________________________________________________
12. ___________________________________________________________________
13. ___________________________________________________________________
14. ___________________________________________________________________
15. ___________________________________________________________________
16. ___________________________________________________________________
17. ___________________________________________________________________
18. ___________________________________________________________________
19. ___________________________________________________________________
20. ___________________________________________________________________
21. ___________________________________________________________________
22. ___________________________________________________________________
23. ___________________________________________________________________
24. ___________________________________________________________________
25. ___________________________________________________________________
Please return to: Pat Martin, MP, Winnipeg Centre, 446 West Block, House of Commons, Ottawa K1A 0A6