Publishing Interest Form
Thank you for your interest in publishing with 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.)
Format: (000) 000-0000.
E-mail Address
*
example@example.com
I am interested in the following: (Please check ALL that apply.)
*
Cover Design (front and/or back)
Interior Design (border, watermark, etc.)
Transcription (audio to text)
Print Material Design (bookmarks, business cards, etc.)
Social Media Banners (IG, FB, YouTube, etc.)
Digital Media/Press Kit
Coaching (teaching the publishing process)
Other
If you checked "Other" above, please briefly state those specific publishing interests.
What is your desired TARGET DATE for release?
*
(This is differs from a deadline.)
Do you have a TYPED manuscript?
*
Yes
No
If "yes," roughly how many pages is it?
*
24 - 100
101 - 200
201+
Has professional proofreading been done for your manuscript?
*
Yes
No
Unsure
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
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 the decision to publish material submitted is at the discretion of MP31 Media (a division of Model P31 Wellness, LLC) following a review of my material.
*
Yes, I understand and agree.
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