TEST Townsville Self-Pub Form

Self-Published and Independently Published Submission Form

Peter Pal receives many applications for consideration, so please be patient. We will review your application as soon as possible.

Please note, a physical copy of your publication must be provided to the below address to be assessed for quality.

Peter Pal Self-Published Authors

48-50 Commercial Drive

Shailer Park, QLD, 4128

Please direct any questions or concerns relating to this form to selfpub@peterpal.com.au

Peter Pal collects the data recorded in the below form to assist with the self-published and independently published review process only. Any data collected is stored on secure servers and will be shared only with Townsville Libraries and no other parties.

Author's Townsville Library Membership Number *Membership numbers should begin with either 'B70' or 'M701' or 'M702' and may contain between 6 and 8 digits

Please upload the front cover of your book here - note, if you have uploaded an image and would like to choose a different image instead, click the red cross to upload a new image.

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Please ensure there are no special characters in the name of your file i.e. " , - ( # $ / ! @ etc. If your file has failed to upload due to special characters in the file name, please close down and reopen your browser, rename your file and try submitting the form again.

Title of Book *

Subtitle (if applicable)

Full name of Author/s *Please separate multiple names with commas

Illustrator/s (if applicable)

ISBN (must be 13 digits, no hyphens) *

Format of book *Not selectedPaperbackHard coverSpiral boundOther (please specify below)Not selectedPlease select one option

If format selected is "other" please specify here

Number of Pages *

Publisher *

Publication Date *

Author's city of residence *Applicants using the Townsville form must reside in Townsville

Author's Postcode *Author must reside within a Townsville postcode

Country of publication

Recommended Retail Price * The Price at which a manufacturer or publisher recommends for a retailer to sell the product

Trade discount percentage % *The percentage of the RRP you offer as discount to Peter Pal

Trade discount price *The price after the discount is subtracted from the RRP

Currency *Not selectedAUDNZDUSDEURCADCHFHKDJPYOtherNot selectedPlease select one option

DESCRIPTION: (max 400 words) *

Audience rating *Not SelectedAdultYoung AdultJuniorProfessional/EducationalNot SelectedPlease select one option

Best contact name should Peter Pal purchase your book *

Best contact number should Peter Pal purchase your book *

Best email address should Peter Pal purchase your book *

Stock on hand *YesNo

Expected lead time for new ordersin business days

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