SUBMISSION FORM

(Please print and mail with signed Agreement)

PERSONAL INFO

NAME (First, Last):
TITLE and AFFILIATION:
ADDRESS:
Street
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EMAIL:
TELEPHONE:
FAX:
TAX ID#
(needed to issue royalty payments)

BOOK INFO

TITLE:
SUBTITLE:
AUTHOR:
CO-AUTHOR(s):
PEER REVIEWERS: List 3 specialists in the field who are qualified to review your manuscript. Provide name, title, affiliation, mailing address, email address, telephone.




















OPTIONS

Fees apply to books of 400 pages or less;
0.50c for each additional page.
Paperback


$1100
Hardcover $1200
Hardcover & Paperback (together) $1800
Reprint
- Manuscript is submitted as Word file
- Optical scanning of hard copy book

$1100
TBD
Add 4% for online payment
Total: $____

PAYMENT

___ I have paid online (link to online credit card processing on SUBMIT page).
___ I have enclosed a check or money order for the amount above

Please mail Submission Form to:

New Academia Publishing, LLC
P.O. Box 27420
Washington, DC 20038-7420