1) Are you the...
Select Published Author Publisher Agent Publicist Friend or Relative of the Author

2) Name of Publisher, Agent, or Person representing the Author

3) Full name of Author

4) Title of one published Book by the above Author

5) ISBN# of published Book

6) Approximate Amazon Sales Rank for the above published book

7) Does the book listed in question #4 contain content that isn't appropriate for young audiences? Does it contain content that may be considered overly indecent or illegal?
Select Yes No

8) How many books do you, or the Author you are representing, have published and available on Amazon?
Select 1 2 3 4 5 6 7 8 9 10 More than 10

9) Authors: Please list your website designed to promote your book(s) or yourself (if applicable):

10) Publishers/Agents: Please list the website designed to promote book(s) that you represent (if applicable):

11) Email Address of Publisher or Agent

12) Is the author in question currently bound to a contract with agent or publisher?
Select Yes No

13) Your Mailing Address

14) Telephone Number (including country code, if outside the USA)