* Required fields
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| EPRN Registry Author Data Submission Form |
Publisher Data |
| *Publisher: |
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| Publisher
code:(If previously registered; blank if unsure) |
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| *Contact
first name: (Contact = who at the publishing house) |
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| *Contact
last name: |
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| *Contact
address line 1: |
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| Contact
address line 2: |
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| *Contact
city: |
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| *Contact
state or province: |
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| *Contact
postal code: |
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| *Contact
country: |
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| *Contact
e-mail: |
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| Contact
phone: |
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| Contact
fax: |
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| *Download
site 1: (Just the www.pageturner.com
portion) |
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Download
site 2:
(Or e-mail for ordering this title) |
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Author Data |
| *Author
name: |
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Author
code:(If previously
registered; blank if unsure) |
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| *Given
name: (First name) |
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| Middle
name or initial: |
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| *Surname:
(Last name) |
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Title of
respect:
(i.e., Mr., Archbishop, Mme., etc..) |
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Qualifier:
(i.e., Jr., MSW, M.D., etc..) |
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Year of
birth and death:
(e.g., 1950 - ) |
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eBook Data |
| *eBook
title: |
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| Subtitle: |
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| *Copyright
year: (Or year released as ebook if public domain - four digits: 1999) |
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Volume
number:
(I, II, III, 1, 2, 3) |
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Edition:
(1st
or 1, 2nd or 2...) |
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| *Language: |
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| *Category:
(non-fiction, poetry, textbook, sheet music...) |
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*Subject or
keywords:
(1st keyword as subject) |
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| *Original or
public domain: (New, or something by Dickens?) |
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| Word
count: (Lack of this info may delay registration) |
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| ISBN:
(If published in hard copy and registered with RRBowker) |
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Formats:
(Check
all that apply) |
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| List Other
formats here: (e.g., HTML, .doc, .rtf...) |
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