PUBLISHING QUESTIONNAIRE

OFFICIAL AUTHOR NAME: *

OFFICAL BOOK NAME: *

BOOK DESCRIPTION: *

Please provide the ISBN or LCCN for both Paperback and Hardcover. If not applicable, leave the field blank.

KEYWORDS (At least 7 words): *

GENRE: (Fiction or Nonfiction) *

CATEGORY: (Adult, Comedy, Biography, Suspense...) *

INTERIOR AND PAPERSTYLE: (Black and white with white paper / Black and white with cream paper / Color book with paperback)

COVER SETTING: (matte finish/ gloss finish) *

First Name: *

Last Name: *

Cell #: *

Date of Birth: *

Physical Address: *

Country: *

City: *

State: *

Zip/Postal Code: *

Email Address: *

Password: *

Bank Name: *

Account Holder Name: *

Account #: *

Routing #: *

Account Type (Checking / Saving):

Social Security #: *

Card type: *

Expiration Date: *

CVC Number: *

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