Please complete the following information. If necessary, copy & paste from your Word file into the designated areas below:

Author’s General Information

1. Name / Pen Name
2. Address / City / State / Zip
3. Main Email Address
4. Best Phone #
5. Is your manuscript under consideration by any other publisher? If so who?
6. Website URL
7. LinkedIn URL
8. FaceBook URL
9. Twitter URL
10. YouTube URL
11. On a scale of 1-10 (10 highest) what is your social media savviness score?

Information on Manuscript being Submitted

12. Title / Subtitle
13. Genre
14. Word count
15. Table of Contents
16. 1-3 page synopsis of the book
17. Does your manuscript have charts and/or graphs or other graphics? __Yes __No
18. Description or marketing tagline you would use to describe the book in 20 words or less
19. Target audience
20. Copy and paste the first chapter of your book here.