Author Application Form
**THIS IS NOT A CONTRACT, THEREFORE THERE IS NO FINANCIAL OBLIGATION***
Welcome! Thank you for your interest in partnering with Jai Publishing House to publish your book. Please note that all responses are password-protected and kept confidential.
The preliminary information provided in this assessment will be carefully reviewed and considered by the Jai Publishing team to determine if your work will be a good fit for the overall objective and our company mission. If you have not done so, please review the "Publish With Us" page on our website at
prior to completing this application.
Complete in its entirety. Incomplete applications will not be considered.
Please allow up to 48 hours after submission for our team to review your application and respond with the next step of scheduling a 30-minute consultation appointment. Again, thank you for your interest and we look forward to serving you!
First and Last Name
(as you want it to appear on the book cover)
(one that you check regularly)
Social Media Handles (Facebook, Twitter, Instagram)
Short Biography (2-3 sentences to describe who you are and what you do)
Title of Book/Main Idea (does not have to be concrete, but a good starting point)
What is your overall objective/goal in publishing your book at this time?
When do you aspire to get started with writing your story or publishing your book project?
What are some important factors to you that aide and assist in your decision-making process in choosing a publishing company?
Which publishing package are you interested in?
Red Package (Standard): $998
Scarlet Package: $1,498
Silver Package: $2,498
Gold Package: $4,498
Blue Package - Picture Book: $3,998
Purple Package - Picture Book: $6,998
Book Collaboration - Champagne Package: $6,498
Book Collaboration - Platinum Package: $9,998
Jump Start Digital Platform [1-Page Website]: $500
Entrepreneur Digital Platform [3-Page Website]: $750
Ultimate Entrepreneur Digital Platform [5-Page Website]: $1,000
Complete Done For You Package: $25,000
Need Help Deciding!
Please select payment option. (First payment due upon signing of contract)
Full payment at once (save 10%)
1/2 down upon signing of contract, remaining 1/2 before printing
$500 down, remaining equal monthly payments (full payment due prior to printing)
Finance entire package
How did you hear about Jai Publishing House?
Page 1 of 2
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service