** Required information -
If you do not fill in these items completely, the contract is invalid.
As owner or Copyright, I authorize Gregath Company, Incorporated to advertise and sell:
**Gregath IBSN _______________________________________________________________
From book inventory I agree to keep with
Gregath Company, Incorporated will forward,
annually, the following
**(check one and fill out completely)
□ payment via check to:
Please include pre-addressed mailing label (choose one) - YES NO
□ delivery mailing information and electronic payment via PayPal (email provided below).
Forwarded payment is figured thusly:
Gregath's retail price, which I have established at **$_______________
less 20% which is **$_______________ (price per book I will receive), times number sold.
I agree to notify The Gregath Publishing Company if there is any other change in the status of the book which may affect the ability of restocking GCI for ISBN sales.
Phone Number ______________________________________________________________
Email Address: ________________________________________________________________
Subscribed and sworn before me,
this _________________ day of _________________________, 20__.
Description of book for Advertisement (optional):
Number of Pages _______
Type of Cover or Electronic Format/Media _______
Does the book contain (please circle) index, photos, maps, documents, coats of arms
Further comments/PR for advertisement and future reference should be placed on reverse or a separate sheet.
Thank you for your interest.
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