Boxes marked with * are required.

Title	Select One Mr. Mrs. Ms.
*Name
*Address
*City
*State/Prov
*Zip/Postal Code
*Country
*Office Phone
Home Phone
Cell Phone
*Email
Website Url
Book Information
*Suggested Title
Suggested Subtitle
*Word Count
Do you have a cover design?	I need XP Publishing to design it I have my own designer
Number of B/W Graphics
Number of Color Graphics
Book Desciption and Author's Bio
*Give a brief summary of your book’s message and benefits
*What makes it unique? Why do others need to read it?
*Who is your target audience?
*Tell us little about yourself, your Christian walk and any ministry associations you may have
*Please give us a couple of references (ministry, church, personal)
*What promotion and distribution opportunities do you have available for selling this book?
Has this work been published before	No Yes
If yes, please explain.
*How many copies of your book are you willing to purchase for your own distribution?
Enter code

Note: We will need to see a copy of the manuscript before we can give a final estimate.