Contact Form (Booksellers)

^* = Required fields

General

Suffix:

^* First Name:

^* Last Name:

^* Email:

^* Confirm Email :

Work Address

^* Company Name:

Title:

Address:

Address Line2:

City:

State: Zip:

Phone Number:

Phone Ext:

Acceptable Call Hours:

(Max 100 characters)

Demographics

QUICK QUESTION: Can you tell us the general demographics of who is buying our book, or who you think our target audience is?

You might think we are being nosy, but as men and women of all ages and backgrounds began to hear about our book, it became obvious that it was relevant to many more people than we could have ever imagined. We want to make sure we understand who are readers really are … so please let us know.

(Max 500 characters)

Contacting you because:
(Check as many as apply)

General Information	Book Orders
Comments & Suggestions	I Have A Question
Book Club (including Guide)	Book Review Submission
Posting For Other Indies	Special Requests (including postcards)
Need A Download	Other

(Max 750 characters)

^* Type Security Code Below: