Winners PLUS Agency, Inc.

P.O. Box 16689

Charlotte, NC 28297-6689

www.winnerplusagency.org

Stay Focused Chronicles Comic Book

Order form

Name ________________________________________________________

Address _______________________________________________________________

City _______________________________ State ___________ Zip code __________

Contact Number ___________________________ #2 __________________________

Please indicate your choices below:

I would like to order _______ copies in English @ $19.99 each for a total of __________

I would like to order _______ copies in Spanish @ $19.99 each for a total of __________

Payment Type: £ Check £ Money Order Total Amount enclosed is $__________

Please make check payable to Winners PLUS Agency, Inc. and mail to address above.

Your order will ship within 10-business days.

Thank you very much for your patronage!