Questionnaire

For Fiction, Non-Fiction and Memoir Writers

Marcia Rosen
Founder and owner
of CreativeBookConcepts

Author of "The Woman's
Business Therapist:
Eliminate the MindBlocks and
RoadBlocks to Success"

Seminars and Individual &
Group Sessions on
"Writing Your Life"

Motivational Speaker:
Eliminate The MindBlocks and
RoadBlocks to Success

Marketing, Public Relations and Think Tank Consultant

Owner of Marketing
and Public Relations Agency
for over 25 years

Please fill out the confidential following form and e-mail or fax to Marcia Rosen, BookConcepts, so I can review what services interest you and determine costs involved.

Please Tell Me About Yourself

First Name

Last Name

Your Email Address

Area Code and Phone

Area Code and Fax

Your Website URL (http://www.yourdomain.com)

Name of Business or Organization

Address

City

State

Zip Code

Please Tell Me About Your Book

Book has been written?

Fiction or Nonfiction?

Book has been published (by whom?)

Title

Number of pages

Do you have a press kit?

Do you have a speaker's kit?

What press have you received to date?

Where have you spoken?

Are you working on a book?

Fiction, Nonfiction or Memoir?

Working Title, if any

Proposal Completed

Do You Have Any Other Thoughts or Questions?

Please review Category A or Category B for list of services and benefits and list below what services you would be considering.

Comments

To schedule a personal consultation and get a copy of
"Free Book Marketing Tips", e-mail Marcia or call (505) 293-2122.