Full Name *

Email Address *

Store/Account Name *

Distributor *

Account Number *

Number of Titles Requesting * If requesting more than one Retailer Exclusive Variant on the same issue, please submit each variant as a separate title.

Select a Number 1 2 3 4 5

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First Title and Issue # Requested *

Requested Cover Treatments Absolute Universe and Batman orders require min. 2,000 units (with min. 1,000 units of Full Trade Dress). All other orders require min. 1,000 units of Full Trade Dress. Additional treatments require min. 1,000 units.

Full Trade Dress (min. 1,000 units) *

Select Units 1,000 2,000 3,000

Full Trade Dress Black & White

Select Units 1,000 2,000 3,000

No Trade Dress

Select Units 1,000 2,000 3,000

No Trade Dress Black & White

Select Units 1,000 2,000 3,000

Foil

Select Units 1,000 2,000 3,000

Foil Black & White

Select Units 1,000 2,000 3,000

Preferred Artists (include at least 3) *

Desired Cover Concept Direction * Wraparound covers will require additional fee.

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Second Title and Issue # Requested *

Requested Cover Treatments Absolute Universe and Batman orders require min. 2,000 units (with min. 1,000 units of Full Trade Dress). All other orders require min. 1,000 units of Full Trade Dress. Additional treatments require min. 1,000 units.

Full Trade Dress (min. 1,000 units) *

Select Units 1,000 2,000 3,000

Full Trade Dress Black & White

Select Units 1,000 2,000 3,000

No Trade Dress

Select Units 1,000 2,000 3,000

No Trade Dress Black & White

Select Units 1,000 2,000 3,000

Foil

Select Units 1,000 2,000 3,000

Foil Black & White

Select Units 1,000 2,000 3,000

Preferred Artists (include at least 3) *

Desired Cover Concept Direction * Wraparound covers will require additional fee.

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Third Title and Issue # Requested *

Requested Cover Treatments Absolute Universe and Batman orders require min. 2,000 units (with min. 1,000 units of Full Trade Dress). All other orders require min. 1,000 units of Full Trade Dress. Additional treatments require min. 1,000 units.

Full Trade Dress (min. 1,000 units) *

Select Units 1,000 2,000 3,000

Full Trade Dress Black & White

Select Units 1,000 2,000 3,000

No Trade Dress

Select Units 1,000 2,000 3,000

No Trade Dress Black & White

Select Units 1,000 2,000 3,000

Foil

Select Units 1,000 2,000 3,000

Foil Black & White

Select Units 1,000 2,000 3,000

Preferred Artists (include at least 3) *

Desired Cover Concept Direction * Wraparound covers will require additional fee.

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Fourth Title and Issue # Requested *

Requested Cover Treatments Absolute Universe and Batman orders require min. 2,000 units (with min. 1,000 units of Full Trade Dress). All other orders require min. 1,000 units of Full Trade Dress. Additional treatments require min. 1,000 units.

Full Trade Dress (min. 1,000 units) *

Select Units 1,000 2,000 3,000

Full Trade Dress Black & White

Select Units 1,000 2,000 3,000

No Trade Dress

Select Units 1,000 2,000 3,000

No Trade Dress Black & White

Select Units 1,000 2,000 3,000

Foil

Select Units 1,000 2,000 3,000

Foil Black & White

Select Units 1,000 2,000 3,000

Preferred Artists (include at least 3) *

Desired Cover Concept Direction * Wraparound covers will require additional fee.

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Fifth Title and Issue # Requested *

Requested Cover Treatments Absolute Universe and Batman orders require min. 2,000 units (with min. 1,000 units of Full Trade Dress). All other orders require min. 1,000 units of Full Trade Dress. Additional treatments require min. 1,000 units.

Full Trade Dress (min. 1,000 units) *

Select Units 1,000 2,000 3,000

Full Trade Dress Black & White

Select Units 1,000 2,000 3,000

No Trade Dress

Select Units 1,000 2,000 3,000

No Trade Dress Black & White

Select Units 1,000 2,000 3,000

Foil

Select Units 1,000 2,000 3,000

Foil Black & White

Select Units 1,000 2,000 3,000

Preferred Artists (include at least 3) *

Desired Cover Concept Direction * Wraparound covers will require additional fee.

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Retailer Logo Details * Please inlcude name/description of logo for back cover. If using multiple logos please indicate order in which they should appear.

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