Get 'Diary of a Broken Mind' at No Charge
This form is for those who don't have the funds at the moment for the book, Diary of a Broken Mind. Several donors have made available books for you. Leave your name, email, and address. This information will not be shared and this is a secure form seen only by me and no one else.
WE CANNOT SHIP COPIES INTERNATIONALLY AND UNFORTUNATELY, I HAVE NOT BEEN ABLE TO SEND EBOOKS INTERNATIONALLY EITHER. If you know how to do this, let me know!
1. Please list your first and last name here
3. In what form would you like the book?
eBook (kindle version)
4. If you chose eBook, list the email associated with your amazon kindle account
5. Enter a full mailing address here. (even an ebook since I can't send a kindle book to other countries)
6. If you chose paperback and you want it personalized, let me know here. (all books will be signed except ebook/kindle)
7. If you want to leave a comment, here would be the place to do that
A copy of your responses will be emailed to the address you provided.
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