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Where did you hear about us?

Author Name or Pen Name

Your primary email address

Phone Number

Address

City

State

Zip Code

Is you manuscript under consideration by any other publisher? Is you manuscript under consideration by any other publisher? Yes No

Please let us know who is/are the other publisher(s)

Do you have any of the following? Do you have any of the following? Website Linkedin Facebook Twitter Youtube Instagram Other None

Website url (i.e. https://www.yourwebsite.com)

LinkedIn Url (i.e. https://www.linkedin.com/linkedinname)

Facebook URL (i.e. https://www.facebook.com/facebookname)

Twitter Url (i.e. https://www.twitter.com/twittername)

Youtube URL (i,e. https://www.youtube.com/youtubename)

Instagram (i.e. https://instagram.com/igname)

Other Urls (i.e. https://socialmedianame.com, https://mysocial.com, etc.)

On a Scale of 1-10 (10 Highest) what is your social media knowledge score? On a Scale of 1-10 (10 Highest) what is your social media knowledge score? 1 2 3 4 5 6 7 8 9 10

On a Scale of 1-10 (10 Highest) how active are you on social media? On a Scale of 1-10 (10 Highest) how active are you on social media? 1 2 3 4 5 6 7 8 9 10

Title / Subtitle

Word Count

What type of book are you submitting? What type of book are you submitting? Fiction Non-Fiction

Has this been professionally edited? Has this been professionally edited? Yes No

Is this part of a series? Is this part of a series? Yes No

Will you have Graphics, Graphs, Illustrations or Pictures in the book? Will you have Graphics, Graphs, Illustrations or Pictures in the book? Yes No

Manuscript Genre

Table of Contents

1-3 Page Synopsis of the book

Description or Marketing Tagline to describe the book in 20 words or less

Target Audience

Copy and paste the first chapter of your book here.