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ORDER FORMPlease complete all fieldsFull NameAddress (Line 1)Address (Line 2)CityState/ProvinceZip/Postal CodeCountryDaytime Phone () -Evening Phone () -e-mail addressSecondary e-mail addressBook TitleSubtitleAuthor’s Name/Pen NameBook uscript FormatMSWORDRTFMACOtherTrim Size Desired6x9 (Our most popular)5.5x8.55x8Cover Design byMy Design(Please include files with manuscript)PoetryChildren’sWasteland Press
GOLD PLAN PRICE MATRIXPlease use the chart below to determine the cost of printing your book. Onceyou have the amount, enter it on the top of page 2 by your plan total.Remember that this Adobe Acrobat file is fully interactive, so you will be ableto fill in the amounts on this form and can be automatically calculated beforeyou print it.NUMBER OF PAGESCOSTS40-125 650.00126-175 795.00176-225 925.00226-275 1015.00276-325 1100.00326-375 1225.00376-425 1325.00426-500 1400.00500 or moreContact Us
GOLD PLAN PUBLISHING RATESOptionOption DescriptionSubtotalTotalGOLD PLANPrinting of 50 paperback copies, Free ISBNand barcode, Color cover, full interior layout,Paperback Royalty: 20%,Kindle eBook Royalty: 50% 0.00 0.00PHYSICAL PROOFPAPERBACK COPYWe will overnight a paperback proofcopy before we print your free copiesand send your book for distribution 50.00 0.00ADDITIONALPAPERBACK COPIESIf you want more than 50 copies, just enterthe number of copies you would like topurchase below. The amount will be calculated0to the right. Enter number of copies:Multiply # 0.00by 0.00LCCN NUMBERWasteland Press will request and assigna Library of Congress Control Numberand mail complimentary copies of yourbook for their stacks 50.00 0.00SEARCH INSIDE THEBOOK PROGRAMWasteland Press will submit files of yourbook to be viewed on Amazon.com’sSearch Inside The Book Program 50.00 0.00APPLE iBOOKS eBookSet-up and distribute your print book forApple’s iBooks program. eBook Royalty: 50% 150.00 0.00NOOK eBOOKSet-up and distribute your print book forNook’s eBook program. eBook Royalty: 50% 50.00 0.00HARDBACKBOOK SET-UPSet-up fee of 250.00 includes full color coverdesign and additional ISBN number fordistribution services. Hardback Royalty: 20% 250.00 0.00HARDBACKBOOK COPIESWith your hardback book set-up, you canpurchase additional hardback books at a lowprice. Just enter the number of copies you0would like to purchase:Multiply # 0.00by 0.00
BUSINESS CARDS(QTY: 1,000)Have 1,000 full color business cards printedwith the front cover of your book and contactinformation designed by Wasteland Press.Includes shipping charge 100.00 0.00POSTCARDS(QTY: 500)Have 500 full color postcards printed with thefront cover of your book and contactinformation designed by Wasteland Press.Includes shipping charge 125.00 0.00BOOKMARKS(QTY: 500)Have 500 full color bookmarks printed withthe front cover of your book and otherinformation designed by Wasteland Press.Includes shipping charge 100.00 0.00POSTERS(QTY: 10)Ten full color posters (measuring 11x17)printed with your front cover of your book.Includes shipping charge 100.00 0.00GRAND TOTAL: 0.00I choose to pay by:Check or Money Order*I have already paid by Online Credit Card Payment*Make checks payable to Wasteland PressSignature Date / /
Cover Design Notes (If Any)Interior Design Notes (If Any)
Publishing AgreementMake sure to sign before mailing.Please read and sign this agreement between you (“Author”) and Wasteland Press (“WastelandPress”) for your manuscript (“Work”), Printed Book (“Book”), and Digital eBook (“eBook”)Author’s Full Name:Manuscript Title:WarrantiesThe Author represents and warrants that he or she is the sole author of the Work and the owner ofthe copyright to all its contents and that he or she has not engaged in plagiarism and that the Work,if fiction, represents no real events or person(s) that in any way could be deemed libelous and theAuthor has the right to enter into this agreement.The Right To Your WorkThe Author acknowledges and agrees that Wasteland Press acquires no right to ownership to theWork under this agreement and assumes no responsibility for reviewing or correcting the content ofthe Work. The Author retains full rights to all related cover images and other Book and eBook relateddigital files from Work and may use these digital files elsewhere. Upon request, Wasteland Press willprovide all Book and eBook related digital files from Work to the Author at no additional charge.Printed Book RoyaltiesOn all sales of printed book copies of the Work via third party wholesalers/retailers, Wasteland Presswill pay the Author a royalty equal to 20% of the payments actually received by Wasteland Press fromsales of printed book copies of Work, less wholesale/retail discounts, shipping and handling charges,sales and use taxes, and returns. Royalties will not be paid on printed book copies provided or sold tothe Author or any third party on behalf of the Author.eBook RoyaltiesOn all sales of eBook copies of the Work via third party wholesalers/retailers, Wasteland Press willpay the Author a royalty equal to 50% of the payments actually received by Wasteland Press fromsales of eBook copies of Work, less wholesale/retail discounts, data and handling charges, sales anduse taxes, and returns. Royalties will not be paid on eBook copies provided or sold to the Author orany third party on behalf of the Author.Initial here
IndemnitiesThe Author agrees to indemnify and hold harmless Wasteland Press and its employees from any andall manner of claims, liabilities, damages, losses, expenses (including attorney’s fees), awards,judgments resulting from claims of third parties regarding ownership, plagiarism, privacy violations,copyright infringement, and similar claims arising from publication of Work.Disclosure of RoyaltiesRoyalty checks and royalty reports are generated every quarter (March–June–September–Decemberof each fiscal year). If sales are recorded, royalty checks will be mailed to the Author the monthafter the quarter has expired. If no sales are recorded, the Author understands that he or she willnot receive a royalty check or royalty report. The Author also understands that royalty reports areavailable at any time, regardless of whether there have been sales or not and can be requested bye-mailing webmaster@wastelandpress.net.Shipping and HandlingThe Author agrees to indemnify and hold harmless Wasteland Press and its employees from anyand all manner of claims, liabilities, damages, losses, expenses (including attorney’s fees), awards,and judgments resulting from damage in shipping or usage of any delivery service deemed fit byWasteland Press.Terms and ExclusivityThe Author retains the copyright for this Work and may choose to enter into other publishingagreements. Either party has the option to terminate the Agreement at any time, with or withoutcause. If the Author prior to Book and eBook publication date terminates the Agreement, the Authoris responsible for payment of pre-publication services, which is 30% of the publication fee and canbe no greater than 999.00. If the Agreement is terminated by Wasteland Press and no breach ofAgreement has occurred, all publication fees will be refunded in full. If the Agreement is terminatedby Wasteland Press due to breach of Agreement by the Author, no fees shall be refunded. If theAgreement is terminated by Wasteland Press or the Author after Book and eBook publication date,then no refund will be due to the Author.Worldwide DistributionThe Author understands and gives permission for Wasteland Press, Lightning Source Inc., IngramBook Group, Amazon, Inc. and any other distributor on behalf of Wasteland Press to distribute andpromote the Author’s Book and eBook worldwide. The Author also understands that his or her Bookand eBook will be available through all or some of the above-mentioned companies for a period ofone year from the publication date of Book and eBook. Thereafter, Wasteland Press will require afee paid by the Author in the amount of 25.00 per year in order for Wasteland Press to continuedistributing the Book and eBook through the above-mentioned companies. The Author alsounderstands if his or her contract is terminated, whether by Wasteland Press or by his or her ownwill, that it may take up to three (3) months for the Author’s Book and eBook to be removed fromthe database of Wasteland Press, Lightning Source, Inc., Ingram Book Group, Amazon, Inc. and anyother distributor utilized by Wasteland Press to distribute Author’s Book and eBook.Initial here
Complete AgreementThis written Agreement contains the sole and entire Agreement between the parties (WastelandPress and Author) and shall supersede any and all other prior agreements between the parties. ThisAgreement may not be modified or amended except in writing signed by the party against whomsuch modifications or amendment is sought to be enforced.I, , attest that I am the sole Author of the manuscript titled:and exclusively own rights to this Title and I agree to the terms and conditionsof this Publishing Agreement.Signature Date / /Please mail your check or money order along with your completed ORDER FORM andPUBLISHING AGREEMENT to:Wasteland Press18 Village Plaza PMB # 177Shelbyville, KY 40065U.S.A.
BOOK PROGRAM Wasteland Press will submit files of your book to be viewed on Amazon.com’s Search Inside The Book Program 50.00 APPLE iBOOKS eBook Set-up and distribute your print book for Apple’s iBooks program. eBook Royalty: 50% 150.00 NOOK eBOOK Set-up and distribute your print book for Nook’s eBook program. eBook Royalty: 50% 50.00 HARDBACK BOOK SET-UP Set-up fee
