Business Registration Form

DREAM BIG Entrepreneur Book Club

Book of the Month Author Inquiry
Book Title *
Author's Name *

First Name Last Name
Business Name *
Contact Number *

Area Code Phone Number
E-mail *
URL *
web address
Please provide a synopsis of your book. *
Book Price *
Wholesale Price *
Shipping Time *
Will you be able to provide signed copies of your book for our club members? *

Yes No
What would you like to share with our DREAM BIG book club members? *
Will you be available to speak with our book club in person or live stream? *

Yes No
Should be Empty:

DREAM BIG Entrepreneur Book Club