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Choice Publishing & Book Services Ltd Barlow House, Narrow West Street, Drogheda, Co Louth, A92 CPF9 Rep of Ireland
Tel: ++353 (0)41 9841551 MOBILE: 089 600 1995 Email: info@choicepublishing.ie Web: www.choicepublishing.ie
Book & Author Information Form
Name of Author: __________________________ Date: _________________
I, the Author, by ticking the relevant box below, herby select the corresponding option.
All Inclusive Package (€2250.00) Gold Package (€1995.00) Silver Package (€1595.00) Basic Package (€ 1150.00) Full Colour Picture Book (€ 1495.00) E-Book Only Package (€ 399.00)
Author Information:
Legal Name of Author: _______________________________________________
Date of Birth: _______________________________________________________
Title of Work: ______________________________________________________
Any additional names appearing on the title page: _________________________
Address: ___________________________________________________________
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Telephone Number: __________________________________________________
Mobile Number: _____________________________________________________
Email Address: ______________________________________________________
Book Information:
Book Title: _________________________________________________________
Desired Final Size: ________________________Retail Price _________________
Approximate Number of pages: _________________________________________
Binding Type: _______________________________________________________
Type of Book & intended audience: ______________________________________
Choice Publishing and Book Services Book & Author Information Form - Page 2
Web Page Information: Keywords/Phrases a potential customer might use while searching your book on the Web:
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Your Full book description: ____________________________________________________________________
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Tell us about you, the author:
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Please choose sample excerpts from your book for your book’s webpage: ____________________________________________________________________
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