Author Interest Form
Author Name:
Email:
*
example@example.com
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Title:
*
Publication Year:
*
Best link to purchase or learn more about this work:
*
Creator Website or Social Media:
Where is your home?
Fort Wayne or Allen County, Indiana
Northeast Indiana
Another part of Indiana
Ohio or Michigan
Elsewhere
Are you interested in donating your published work to the ACPL Local Author collection?
*
Yes
No
Are you interested in being a guest on our local author podcast?
*
Yes
No
Please share a brief biography (up to 100 words):
0/100
Link to headshot or author photo, if available:
Our podcast guests usually share a brief reading from a recent publication. What passage would you read on our show?
If there's a specific idea, topic, or theme you'd like to talk about on our podcast, please share it here:
Are you interested in being a presenter at a future ACPL program?
*
Yes
No
What kind of program presentation are you interested in?
Sharing about my creative process and publishing experience
Offering a writing program or workshop
Offering a program about my topical area of expertise
What area of expertise would you like to share?
Submit
Should be Empty: