PO Box 17  --- Chicago Park, Ca. 95712                       530-277-8236
Common Stock = $ 1.00 per share (20 share minimum)  
Builders Club = 1,000 to 9,999 shares
Presidents Club = 10,000 + shares 
   Dear Rev. Marcum;
 
I would like to help you build Grizzly Mountain Park so together we can help people in need. I relize that I can expect my stock certificate in about 2 to 3 weeks.
Print this form and mail to the address above
Please issue the stocks certificates to the following people
Ordered By

Name
Address
City
State & Zip
Phone
E-mail
Name
Address
City
State & Zip
Amount of shares
Phone
E-mail
Certificate #  Office use only
Name
Address
City
State & Zip
Amount of shares
Phone
E-mail
Certificate #  Office use only
Name
Address
City
State & Zip
Amount of shares
Phone
E-mail
Certificate #  Office use only
Name
Address
City
State & Zip
Amount of shares
Phone
E-mail
Certificate #  Office use only
Please enter the total amount of stock ordered
Qty
Total
Total amount inclosed
Signture