Young and Published Application Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which tier are you in?
*
Tier I (13-18)
Tier II (19-26)
How would you like to be published?
Self-published (I want to earn 60-70% in royalties, handle my own book marketing, and manage my publishing platforms. I know I will have the option to pay for a marketing package if needed. I want full creative control.)
Traditional publishing (I want to earn 30% in royalties, have you handle marketing and manage my publishing platforms for the life of the book. I know the publisher will have full creative control.)
I'm not sure. I need more information.
Academic Information for Tier I Applicant (Skip if you are Tier II)
Grade or Year Level
Date Expected to Graduate
-
Month
-
Day
Year
Date
Are you a member of any organization in your school? Please provide information.
Are you a member of any organization outside your school? Please provide information.
Education Information
Name of School
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Book Information
Name of Book
Book Genre
Please Select
Fiction
Nonfiction
Poetry
Why do you want to be an author?
Please upload a sample of your COMPLETED book. (Sample must be 3 Full chapters.)
Browse Files
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I AFFIRM THAT ALL STATEMENTS I HAVE INDICATED HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY MISREPRESENTATION I HAVE MADE CAN CAUSE FOR THE INVALIDATION OF MY APPLICATION AND SHALL BAR ME FROM RE-APPLYING FOR THE SAME.
Applicant's Signature
Date Signed by Applicant
-
Month
-
Day
Year
Date
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