Author Publishing Application
CoolBird Publishing House
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
How can we help you?
*
Please Select
Full-Service Book Publishing
Course Creation & Design
Editing & Proofreading Only
Book Cover Design Only
Book Promotion Video & Voiceover Only
Copyright Application Only
Ebook or Audio Book Only
If you have started, how many pages do you have?
*
If you have started, what is the word count?
*
What is the name of your book?
*
Is it fiction or non fiction?
*
Tell us the purpose for writing your book?
*
How do you hope your book will impact readers?
*
Who is your message for (your target audience)?
*
When do you want to have your project completed?
*
Who is your target market and how do you plan to market your project?
*
If you are chosen to publish your project, will you be able to attend new author orientation?
*
Book Proposal: What is the status of your project?
*
Please Select
100% Complete
75% Complete
50% Complete
Not Started
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform