Author’s Name:

Address:

Telephone Number:                                                                

Fax Number:

Email Address:

TITLE OF MANUSCRIPT:

Please give a brief description of your manuscript:

Approximate number of words:

If poetry, number of poems:

Will your book include illustrations, if so how many?

Have you submitted your work to other publishers?

If so, what was their response?

Where did you learn of Apex Publishing Ltd?