St. Joseph Bancorp (SJBA) S-1 IPO registration

Exhibit 99.5

St. Joseph Bancorp, Inc. Subscription & Community Offering Stock Order Form
Midwest Federal Savings and Loan Association of St. Joseph Conversion Center 1901 Frederick Ave. St. Joseph, MO 64501 ___-__-__	Expiration Date for Stock Order Forms: __day ____ __, 2008 4:30 p.m., Central time (received not postmarked)
IMPORTANT: A properly completed original stock order form must be used to subscribe for common stock. Copies of this form are not required to be accepted. Please read the Stock Ownership Guide and Stock Order Form Instructions as you complete this form.

(1) Number of Shares	Subscription   Price   × 10.00 =	(2) Total Payment Due	Minimum number of shares: 25 shares ($250)
		$	Maximum number of shares: 20,000 shares ($200,000), subject to adjustment
			Maximum number of shares for associates or group: 20,000 shares ($200,000),
			subject to adjustment
			See Instructions.

(3) Employee/Officer/Director Information
oCheck here if you are an employee, officer or director of Midwest Federal Savings or member of such person’s immediate family living in the same household.
(4) Method of Payment by Check		Total Check Amount	$
Enclosed is a check, bank draft or money orderpayable to St. Joseph Bancorp, Inc. in the amount indicated in this box.					.
(5) Method of Payment by Withdrawal -The undersigned authorizes withdrawal from the following account(s) at Midwest Federal Savings. There is no early withdrawal penalty for this form of payment. Individual Retirement Accounts maintained at Midwest Federal Savings cannot be used unless special transfer arrangements are made.
Bank Use	Account Number(s) To Withdraw			$ Withdrawal Amount
			$		.
			$		.

(6) Purchaser Information
Subscription Offering:
o	a.	Check here if you are an Eligible Account Holder with a deposit account(s) totaling $50.00 or more on June 30, 2007.
o	b.	Check here if you are a Supplemental Eligible Account Holder with a deposit account(s) totaling $50.00 or more on September 30, 2008 but are not an Eligible Account Holder.
o	c.	Check here if you are an Other Member with a deposit account(s) on ______ __, 2008 or a borrower with a loan outstanding as of July 9, 2008 that continued to be outstanding as of _____ __, 2008 but are not an Eligible Account Holder or Supplemental Eligible Account Holder.
Community Offering
o	d.	Check here if you are a community member (Indicate county of residence in #9 below).
Account Information
List below all accounts in which you had an ownership interest as of the applicable eligibility date as indicated in a, b or c above.Failure to list all your eligible accounts, or providing incorrect information, may result in the loss of part or all of your subscription rights. Use reverse side for additional space.

Bank Use Account Number(s) Account Title (Name(s) on Account)

(7) Form of Stock Ownership & SS# or Tax ID#:								SS#/Tax ID#
o	Individual	o	Joint Tenants	o	Tenants in Common	o	Fiduciary (i.e., trust, estate)
o	Uniform Transfers to Minors Act (Indicate SS# of Minor only)			o	Company/Corporation/ Partnership	o  IRA or other qualified plan (Both Tax ID# & SS# for IRAs)		SS#/Tax ID#
(8) Stock Registration & Address:Name and address to appear on stock certificate. Adding the names of other persons who are not owners of your qualifying account(s) will result in the loss of your subscription rights.

Name:
Name Continued:
Mail to- Street:
City:			State:	Zip Code:
(9) Telephone Daytime/Evening	(               )                    --	(               )                          --			County of Residence
(10) Associates/Acting in Concert
oCheck here and complete the reverse side of this form if you or any associates or persons acting in concert with you have submitted other orders for shares.

(11) Acknowledgement -To be effective, this stock order form must be properly completed and physically received (not postmarked) by St. Joseph Bancorp, Inc. no later than 4:30 p.m., Central time, on ______ __, 2008, unless extended; otherwise this stock order form and all subscription rights will be void. The undersigned agrees that after receipt by St. Joseph Bancorp, Inc., this stock order form may not be modified, withdrawn or canceled without St. Joseph Bancorp, Inc.’s consent and if authorization to withdraw from deposit accounts at Midwest Federal Savings has been given as payment for shares, the amount authorized for withdrawal shall not otherwise be available for withdrawal by the undersigned. Under penalty of perjury, I hereby certify that the Social Security or Tax ID Number and the information provided on this stock order form are true, correct and complete and that I am not subject to back-up tax withholding. It is understood that this stock order form will be accepted in accordance with, and subject to, the terms and conditions of the plan of conversion of Midwest Federal Savings described in the accompanying prospectus.
Federal regulations prohibit any person from transferring, or entering into any agreement, directly or indirectly, to transfer the legal or beneficial ownership of subscription rights or the underlying securities to the account of another. Midwest Federal Savings and Loan Association of St. Joseph and St. Joseph Bancorp, Inc. will pursue any and all legal and equitable remedies in the event they become aware of the transfer of subscription rights and will not honor orders known by them to involve such transfer. Under penalty of perjury, I certify that I am purchasing shares solely for my account and that there is no agreement or understanding regarding the sale or transfer of such shares, or my right to subscribe for shares.				Bank Use
By signing below, I also acknowledge that I have read the Certification Form on the reverse side of this form.
Signature	Date	Signature	Date

Item (6) Purchaser Account Information continued:
Bank Use	Account Number(s)	Account Title (Name(s) on Account)

Item (10) Associates/Acting In Concert continued: If you checked the box in item #10 on the reverse side of this form, list below all other orders submitted by you or associates (as defined below) or by persons acting in concert with you (also defined below).
Name(s) listed on other stock order forms		Number of shares ordered
Associate - The term “associate” of a particular person means:
	(1)a corporation or organization, other than Midwest Federal Savings and Loan Association of St. Joseph, St. Joseph Bancorp, Inc. or a majority-owned subsidiary ofMidwest Federal Savings and Loan Association of St. Joseph or St. Joseph Bancorp, Inc., of which a person is a director, officer or partner, or beneficially owns, directly or indirectly, 10% or more of any class of equity securities of such corporation or organization;
	(2)a trust or other estate in which a person has a substantial beneficial interest or as to which a person serves as trustee or in a similar fiduciary capacity; provided, however, that such term shall not include any tax-qualified employee stock benefit plan of Midwest Federal Savings and Loan Association of St. Joseph or St. Joseph Bancorp, Inc. in which such person has a substantial interest or may serve as trustee or in a similar fiduciary capacity; and
	(3) any person who is related by blood or marriage and who either has the same home as a person or who is a director or officer of Midwest Federal Savings and Loan Association of St. Joseph or St. Joseph Bancorp, Inc. or any of their subsidiaries.
Acting in concert –The term “acting in concert” means:
	(1) knowing participation in a joint activity or interdependent conscious parallel action towards a common goal whether or not pursuant to an express agreement; or
	(2) a combination or pooling of voting or other interests in the securities of an issuer for a common purpose pursuant to any contract, understanding, relationship, agreement or other arrangement, whether written or otherwise.
	In general, a person who acts in concert with another party will also be deemed to be acting in concert with any person who is also acting in concert with that other party.
	We may presume that certain persons are acting in concert based upon various facts, among other things, joint account relationships, common addresses on our records and the fact that such persons may have filed joint Schedules 13D or 13G with the Securities and Exchange Commission with respect to other companies.
CERTIFICATION FORM
I ACKNOWLEDGE THAT THIS SECURITY IS NOT A DEPOSIT OR ACCOUNT AND IS NOT FEDERALLY INSURED OR GUARANTEED BY THE FEDERAL DEPOSIT INSURANCE CORPORATION, AND IS NOT INSURED OR GUARANTEED BY MIDWEST FEDERAL SAVINGS AND LOAN ASSOCIATION OF ST. JOSEPH, ST. JOSEPH BANCORP, INC., THE FEDERAL GOVERNMENT OR BY ANY GOVERNMENT AGENCY. THE ENTIRE AMOUNT OF AN INVESTOR’S PRINCIPAL IS SUBJECT TO LOSS.
If anyone asserts that this security is federally insured or guaranteed, or is as safe as an insured deposit, I should call the Regional Director of the Dallas Regional Office of the Office of Thrift Supervision at (972) 277-9500.
I further certify that, before purchasing the common stock, par value $0.01 per share, of St. Joseph Bancorp, Inc. (the “Company”), the holding company for Midwest Federal Savings and Loan Association of St. Joseph, I received a prospectus of the Company dated _____, 2008 relating to such offer of common stock.
The prospectus that I received contains disclosure concerning the nature of the common stock being offered by the Company and describes in the “Risk Factors” section beginning on page __, the risks involved in the investment in this common stock, including but not limited to the following:
Risks Related to Our Business
We have not generated significant profits over the past few years and there can be no assurance that we will generate profits in the future or that our earnings will increase.
Our growth strategy will increase our expenses and may not be successful.
Our business plan to diversify and expand our loan portfolio into commercial real estate, construction lending and consumer lending will expose us to increased lending risks.
Changes in interest rates could have a material adverse effect on our operations.
The loss of our President and Chief Executive Officer would hurt our operations.
Strong competition within our market area may limit our growth and profitability.
If our allowance for loan losses is not sufficient to cover actual loan losses, our earnings will decrease.
Because most of our borrowers are located in our market area, a downturn in the local economy or a decline in local real estate values could cause an increase in nonperforming loans, which could reduce our profits.
Expected voting control by management and employees could enable insiders to prevent a merger that may provide that shareholders receive a premium for their shares.
Risks Related to this Stock Offering
We will need to implement additional finance and accounting systems, procedures and controls in order to satisfy our new public company reporting requirements.
The relatively small amount of stock being offered makes it unlikely that an active and liquid trading market for the stock will develop, and the liquidity and price of the stock may be adversely affected by a limited trading market.
The market for stock of financial institutions has been unusually volatile recently, and our stock price may decline when trading commences.
Our return on equity will be low compared to other financial institutions. This could negatively affect the trading price of our shares of common stock.
Our stock-based benefit plans will increase our costs, which will reduce our income.
The implementation of stock-based incentive plans will dilute your ownership interest.
We have broad discretion in using the proceeds of the stock offering. Our failure to effectively use such proceeds could reduce our profits.
Our stock value may be negatively affected by federal regulations that restrict takeovers.
The corporate governance provisions in our articles of incorporation and bylaws, and the corporate governance provisions under Maryland law, may prevent or impede the holders of our common stock from obtaining representation on our Board of Directors and may impede takeovers of the company that our board might conclude are not in the best interest of St. Joseph Bancorp, Inc. or its stockholders.
(By Signing the Front of this Form the Investor is Not Waiving Any Rights Under the Federal Securities Laws, Including the Securities Act of 1933 and the Securities Exchange Act of 1934)

    St. Joseph Bancorp, Inc.

Stock Ownership Guide
Individual
Include the first name, middle initial and last name of the shareholder. Avoid the use of two initials. Please omit words that do not affect ownership rights, such as “Mrs.”, “Mr.”, “Dr.”, “special account”, “single person”, etc.
Joint Tenants
Joint tenants with right of survivorship may be specified to identify two or more owners. When stock is held by joint tenants with right of survivorship, ownership is intended to pass automatically to the surviving joint tenant(s) upon the death of any joint tenant. All parties must agree to the transfer or sale of shares held by joint tenants.
Tenants in Common
Tenants in common may also be specified to identify two or more owners. When stock is held by tenants in common, upon the death of one co-tenant, ownership of the stock will be held by the surviving co-tenant(s) and by the heirs of the deceased co-tenant. All parties must agree to the transfer or sale of shares held by tenants in common.
Uniform Transfers to Minors Act (“UTMA”)
Stock may be held in the name of a custodian for a minor under the Uniform Transfers to Minors Act of each state. There may be only one custodian and one minor designated on a stock certificate. The standard abbreviation for Custodian is “CUST”, while the Uniform Transfers to Minors Act is “UTMA”. Standard U.S. Postal Service state abbreviations should be used to describe the appropriate state. For example, stock held by John Doe as custodian for Susan Doe under the Missouri Uniform Transfers to Minors Act will be abbreviated John Doe, CUST Susan Doe UTMA MO (use minor’s social security number).
Fiduciaries
Information provided with respect to stock to be held in a fiduciary capacity must contain the following:
•	The name(s) of the fiduciary. If an individual, list the first name, middle initial and last name. If a corporation, list the full corporate title (name). If an individual and a corporation, list the corporation’s title before the individual.
•	The fiduciary capacity, such as administrator, executor, personal representative, conservator, trustee, committee, etc.
•	A description of the document governing the fiduciary relationship, such as a trust agreement or court order. Documentation establishing a fiduciary relationship may be required to register your stock in a fiduciary capacity.
•	The date of the document governing the relationship, except that the date of a trust created by a will need not be included in the description.
•	The name of the maker, donor or testator and the name of the beneficiary.
An example of fiduciary ownership of stock in the case of a trust is: John Doe, Trustee Under Agreement Dated 10-1-93 for Susan Doe.
Stock Order Form Instructions
Items 1 and 2 - Number of Shares and Total Payment Due
Fill in the number of shares that you wish to purchase and the total payment due. The amount due is determined by multiplying the number of shares by the subscription price of $10.00 per share. The minimum purchase in the subscription offering is $250 (25 shares) of common stock. As more fully described in the plan of conversion outlined in the prospectus, the maximum purchase in any category of the subscription offering is $200,000 (20,000 shares) of common stock, and the maximum purchase in the community offering (if held) by any person, is $200,000 (20,000 shares) of common stock. No person, together with associates and persons acting in concert with such person, may purchase in the aggregate more than $200,000 (20,000 shares) of common stock. However, in the event that fewer than 400,000 shares are sold in the offering, the maximum purchase limitation will be reduced to 5.0% of the shares sold and any shareholder who subscribed for more than that amount will have their order reduced to that amount and receive a refund for the difference with interest at our regular savings rate.
Item 3 - Employee/Officer/Director Information
Check this box to indicate whether you are an employee, officer or director of Midwest Federal Savings or a member of such person’s immediate family living in the same household.
Item 4 - Method of Payment by Check
If you pay for your stock by check, bank draft or money order, indicate the total amount in this box. Payment for shares may be made by check, bank draft or money orderpayable to St. Joseph Bancorp, Inc. Cash must be converted to a bank check or money order. Your funds will earn interest at Midwest Federal Savings’ regular savings rate of interest until the stock offering is completed.
Item 5 - Method of Payment by Withdrawal
If you pay for your stock by a withdrawal from a deposit account at Midwest Federal Savings, indicate the account number(s) and the amount of your withdrawal authorization for each account. The total amount withdrawn should equal the amount of your stock purchase. There will be no penalty assessed for early withdrawals from certificate accounts used for stock purchases.This form of payment may not be used if your account is an Individual Retirement Account.
Item 6 – Purchaser Information
Subscription Offering
a.	Check this box if you had a deposit account(s) totaling $ 50.00 or more on June 30, 2007 (“Eligible Account Holder”).
b.	Check this box if you had a deposit account(s) totaling $50.00 or more on September 30, 2008 but are not an Eligible Account Holder (“Supplemental Eligible Account Holder”).
c.	Check this box if you had a deposit account(s) on _____ __, 2008 or a loan outstanding as of July 9, 2008 that continued to be outstanding as of _____ __, 2008 but are not an Eligible Account Holder or Supplemental Account Holder (“Other Member”).
Please list all account numbers and all names on accounts you had on these dates in order to insure proper identification of your purchase rights.Note: Failure to list all your eligible accounts, or providing incorrect information, may result in the loss of part or all of your subscription rights.
Community Offering
d.	Check this box if you are a community member (Indicate county of residence in item 9).
Items 7 and 8 - Form of Stock Ownership, SS# or Tax ID#, Stock Registration and Mailing Address
Check the box that applies to your requested form of stock ownership and indicate your social security or tax ID number(s) in item 7. Complete the requested stock certificate registration, mailing address in item 8. The stock transfer industry has developed a uniform system of shareholder registrations that will be used in the issuance of your common stock. If you have any questions regarding the registration of your stock, please consult your legal advisor. Stock ownership must be registered in one of the ways described above under “Stock Ownership Guide.” Adding the names of other persons who are not owners of your qualifying account(s) will result in the loss of your subscription rights.
Item 9 – Telephone Number(s) and County
Indicate your daytime and evening telephone number(s) and county. We may need to call you if we have any questions regarding your order or we cannot execute your order as given.
Item 10 – Associates/Acting in Concert
Check this box if you or any associate or person acting in concert with you (as defined on the reverse side of the stock order form) has submitted another order for shares and complete the reverse side of the stock form.
Item 11– Acknowledgement
Please review the prospectus carefully before making an investment decision. Sign and date the stock order form where indicated. Before you sign, review the stock order form, including the acknowledgement and certification. Normally, one signature is required. An additional signature is required only when payment is to be made by withdrawal from a deposit account that requires multiple signatures to withdraw funds.
Your properly completed signed stock order form and payment in full (or withdrawal authorization) at the subscription price must be physically received (not postmarked) by St. Joseph Bancorp, Inc. no later than 4:30 p.m., Central time, on ______ __, 2008 or it will become void.
Delivery Instructions: You may deliver your stock order form by mail using the enclosedstock order return envelope,byhand delivery to the Midwest Federal Savings main office, orby overnight courier to the conversion center address indicated on the front of the stock order form.
If you have any remaining questions, or if you would like assistance in completing your stock order form, you may call our conversion center at (___) ___-____, Monday through Friday, between the hours of 10:00 a.m. and 4:00 p.m., Central time. Please note that the conversion center will be closed from 12:00 noon Wednesday, November 26 through 12:00 noon Monday, December 1, in observance of the Thanksgiving holiday.
Midwest Federal Savings Conversion Center
1901 Frederick Ave., St. Joseph, MO 64501