For the purpose of facilitating access to consumer goods by providing necessary funds for Chicago Market’s proposed retail grocery store, and to acquire an ownership interest in Chicago Market, I hereby purchase an ownership interest for .

The ownership interest hereby purchased is intended to confer the right to purchase consumer goods and services at owner prices and to participate in the governance of Chicago Market in accordance with its bylaws. The ownership interest hereby will entitle the holder to no dividends or other monetary return, will be nontransferable except to Chicago Market, will be redeemable only in limited circumstances in accordance with the bylaws of Chicago Market, and will be subject to other terms and conditions in Chicago Market’s bylaws.

The funds remitted hereby are intended to be used to fund the development of Chicago Market, including the securing of additional financing to Chicago Market. All such funds are subject to the risks inherent in any start-up enterprise of this character and may result in the loss of part or all of such funds. Persons who cannot afford to incur such losses should not purchase ownership interests in Chicago Market.

I authorize Chicago Market to use my name and likeness for any lawful purpose, including, without limitation, in promotional materials and electronic communications.