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RESOURCE PROVIDER FORM
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People need help. One of the goals associated with the book series, A Promise of Revenge, is to educate while entertaining. If you provide resources in the form of articles, newsletters, books and other media, services or other resources, and you would like to offer them as a link on this web site, please complete this form. If you have this information in an existing e-mail, you may send that to me instead. But
completing this form will allow me to process the information faster and easier. Your listing here is at no charge to you. We reserve the right to select participants, and to edit, delete or discontinue this service at anytime. Please allow
up to ten business days for a response.
1. First name:
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2. Last name:
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3. Your e-mail address:
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4. How what category or categories of help do you provide?
Book promotion
Help with reducing child bullying
Relationships
Self improvement
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Other help (general information) :
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5. Your telephone number:
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6. Your web site URL:
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7. Your web site #2 URL:
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8. Your web site #3 URL:
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9. Give a short description about yourself or your company:
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10. What is the specific help you provide? Here you may list books, articles, products, services, etc.
If you will provide URL addresses for these items, this would be extremely useful:
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11. How may readers contact you? Give details of e-mail,
telephone, address, etc., whatever means you choose :
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12. Do you offer any bonus gifts or free items, and if so, what are they?:
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13. Give the name of any newsletter, radio show or book club that you host:
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14. Give the web address for the media referenced above:
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15. Give the name of the second newsletter, radio show or book club that you host:
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16. Give the web address for the media referenced above:
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17. Give the name of the third newsletter, radio show or book club that you host:
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18. Give the web address for the media referenced above:
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19. How did you hear about this site?
A popular search engine
Link from another site
From a friend
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Other source (please tell us who or where):
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20. If you have any comments or suggestions
for this site, please add them below:
Please do not send attachments
unless requested. This e-mail system sometimes
treats multiple submissions with attachments as s*pam.
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NOTE: THE INFORMATION PROVIDED IN THE
STARRED FIELDS WILL NOT APPEAR ON THE WEB PAGE.
THIS IS PRIVATE CONTACT INFORMATION. COMPLETE
THE STARRED FIELDS IF YOU ARE A PUBLICIST, AN AGENT
OR OTHER THIRD PARTY
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21. Your first name*:
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22. Your last name*:
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23. Your e-mail address*:
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24. Your telephone number*:
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25. Your address*:
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