Publishing Interest Form
Thank you for your interest in MP31 Media! Please complete the information below.
Name
*
First Name
Last Name
Phone Number
*
(This should be your cell phone number if you prefer contact via text.)
E-mail Address
*
example@example.com
I am interested in the following: (Please check ALL that apply.)
*
Cover Design
Interior Design (border, watermark, etc.)
Proofreading & Editing
Transcription (audio to text)
Coaching
Website Design & Set-up
Digital Media Kit
Print Material Design
Social Media Banners
Expedited Service
If you checked "Other" above, please briefly state those specific publishing interests.
What is your desired target date for release?
*
Do you have a typed manuscript?
*
Yes
No
If "yes," roughly how many pages is it?
24 - 100
101 - 200
201 - 299
300+
Is the material being submitted your ORIGINAL work (including any photos, drawings, and logos)?
*
Yes
No
If you checked "No" to the previous question, do you have DOCUMENTED permission to use the material being submitted?
Yes
No
In which format(s) are you interested? (Please check ALL that apply.)
Paperback
Hard Cover
E-book
What is your preferred method of contact?
*
Email
Phone
Text
What is the best time of day to contact you?
*
9:00 a.m. to noon
Noon to 4:00 p.m.
5:00 p.m. to 7:00 p.m.
Please provide any additional information regarding wishes for publishing your project.
I understand that material submitted for publishing is at the discretion of MP31 Wellness/MP31 Media following a review of my material.
*
Yes, I understand and agree.
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