Submission Form

UK and Commonwealth Authors

WordShack Publishing - United Kingdom

Ben Bernstein, CEO
European Operations
2 The Avenue
London, England
N2 2LB
Telephone: 0044 7956 229050
Email: ukeditor@wordshack.com

US and Canadian Authors

WordShack Publishing - USA

Lynda Blankenship, CEO
North American Operations
958 Oakhill Drive N.E.
Massillon, Ohio 44646
United States of America
Telephone: 330-832-0717
Mobile: 330-313-6044
Email: blankenship@sssnet.com

I, the undersigned, do guarantee that the work being submitted to WordShack Publishing for publication on its website is original and created by me.

I also guarantee that names have been manufactured, by the author, unless otherwise stated.

The title of the work being submitted is:

_____________________________________________________

The name I wish to publish under is:

_____________________________________________________

I understand that WordShack Publishing has the right to place my work on their Internet website, and no place else.

I further understand that any inquiries received by WordShack Publishing in my work will be immediately communicated to me.

I have attached my publication fee of ____________ dollars or ____________pounds.

I have prepaid my publication fee of ___________with PayPal.

I understand that this fee will allow my work to remain featured on WordShack Publishing for a period of six months.

By placing my signature on this document, I accept that my work can not be monitored by WordShack Publishing for copyright infringement. I also understand that copyrighting is the responsibility of the author.

I also understand that the author retains all ownership of the above mentioned work.

Signature

__________________________________    Date ___________

Mailing Address

______________________________________________________________________

E-Mail Address ________________________________________

Phone Number __________________________________