Please complete the online form below and submit it by 5 p.m. on Sunday, October 21, 2018.

Personal Information

Name:*

Home Address:*

Phone Number:*

Business Phone Number:

Email Address:*

Publishing Information

Book Title:*

Self-Published?*

Yes

No

Book Publisher:

Book description or summary (this information may be used in publicity for the event. Please know that some information may be edited due to space limitations):*

Please list any other books and/or items you may want to sell and their prices.*

I understand that 10% of all proceeds from anything sold during the 2018 Local Author Event must be contributed to the Friends of the Wayne County Public Library. Payment is due at the completion of the program either in the form of cash or a check made payable to the Friends of the Library.*

Yes

No

By typing my name in the space provided, I understand that, if this application is approved, I am scheduled to appear at the Wayne County Public Library, Gertrude Weil Auditorium, 1001 East Ash Street, Goldsboro on Saturday, December 1, 2018 from 11:30-2:30 pm (this allows time for you to set up before the 12 p.m. event). I agree that I will be provided tabletop space to promote the book and/or promotional materials as described on this application, and that I am responsible for my my own monies, including making change. If I am unable to make it to this event, I will give notice at least a week in advance by email or by phone to the library. *