First Name *

Last Name *

Mobile Phone *

Email *

Address *

City *

State *

Postal code *

Book Title

Book Subtitle

When do you want to Publish your Book? *

3-6 Months

6-9 Months

12+ Months

Genre *

Which of the following best describes you? (check one or more boxes) *

What is your publishing budget *

$22,000-$30,000

$40,000-$60,000

$30,000-$40,000

$60,000-$120,000

Are you an implementer and an action taker, and willing to follow a proven process? *

Is your book motivational, educational, or inspirational? *

Do you value a partner who will help you get this done with excellence? *

What business objectives do you hope to achieve with this book? *

Grow my authority and thought leadership status

Generate leads/customers for my primary business

Receive speaking invitations

Make money selling copies of my book

Website

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