Self- Publishing Intake Form

Full Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Location?*

List City & State

What is the projected Title of the book?*

Title of the Book

Book Word Count?*

List Pages / Word Count

Do you require an ISBN for your book?*

YesNoOther

Please Provide a Brief Synopsis of your book

Give a brief overview of your book (Please note we provide an NDA to protect you, as well as ourselves).

Have you previously published any books? if yes, please list them, and platform they are listed on.

List the title of book published and what platform (e.g. Kay's Dream - Amazon, etc..)

What stage is your manuscript currently in?

e.g. Idea only, Partially written, Completed manuscript, Other (Please Specify above).

What type of book format are you interested in?

Services Requested? Illustration / Ghost Writing / Editing*

List which service is applicable

If you requires illustration describe the type and style of illustrations you envision?*

e.g. Cartoon, Realistic, Chibi, Line Art, Watercolor, Pen & Ink, Digital, Woodcut, Collage, Charcoal, Pastel, Acrylic, Graphit, Silhouette, Etching, Litography

Do you require other graphic design services?*

e.g. Cover, design, layout

Are you interested in marketing services for your book?*

YesNoOther

Target Audience?*

e.g. children, young adults, adults

What genre of book are you trying to get published

Fiction (Literary Fiction • Mystery • Thriller • Horror • Historical Fiction • Romance • Science Fiction • Fantasy • Dystopian • Adventure • Contemporary Fiction • Speculative Fiction • Magical Realism • Young Adult (YA) • Children’s Fiction • Western)Non-Fiction ( Biography • Autobiography • Memoir • Self-help • Motivational • Health & Wellness • History • Travel • True Crime • Religion & Spirituality • Science • Business & Economics • Cooking & Food • Parenting & Families • Art & Photography • Music • Political Science • Philosophy • Education)Poetry ( • Narrative Poetry • Lyric Poetry • Epic Poetry • Satirical Poetry • Haiku)Drama (• Comedy • Tragedy • Tragicomedy • Historical Drama)Graphic Novels ( • Superhero • Manga • Historical • Fantasy • Science Fiction • Memoir)Other

What are your main goals for publishing this book?

Please describe (e.g. reach a specific audience, share a personal story, commercial success, etc.)

Are you ok with signing an NDA? We request our process be kept strictly private, and that the forms and process detailed is not repeated.*

YesNoOther

Are there any other services or support you need from us?

Please describe

Please provide any additional information or comments that might help us better understand your project and needs.*

Please describe here

Are you a Veteran?, if so what branch did you serve, and how long?

Welcome to Eloa P. Gray, Incorporation, as well as our publishing company under Echelon Divine Solutions who handles all our self-publishing request.

Eloa P. Gray Incorporation oversees and manages multiple high-performing, multi-million-dollar companies, and in doing so have the liquid capital to help fund businesses, flips, and other adventures. My decision to help is guided by the information I receive from the Holy Spirit and I do not operate outside of it. For years I provided interest free loans, and many have decided not to pay me back which have resulted in court cases in which they were left to pay me back, to include my attorneys, and damages.

I ask that you remain transparent, and understand that prior to providing any loan it goes through the trustee board. I take the advice from the trustee very serious, and will not go outside of their recommendation/(s).

I trust that if I choose to provide you with a loan you will repay as detailed on the written contract.

Any question, please email admin@eloapgray.com, or call the company phone number at: 240-858-1711.

By signing below you are agreeing to proceeding with the requested services. An overview will be done, followed by an NDA and detail payment insturction folowing signed NDA.

Signature

Self Publishing Intake Form