with Karen Whiting

GPCWC 2017 Application

Application due no later than June 30

Date:	mm/dd/yyyy format
Title:
First Name:
Mid Init:
Last Name:
Address:
City:
State:	Select ** -- **Blank** AK -- Alaska AL -- Alabama AR -- Arkansas AZ -- Arizona CA -- California CO -- Colorado CT -- Connecticut DC -- District of Columbia DE -- Delaware FL -- Florida GA -- Georgia GU -- Guam HI -- Hawaii IA -- Iowa ID -- Idaho IL -- Illinois IN -- Indiana KS -- Kansas KY -- Kentucky LA -- Louisiana MA -- Massachusetts MD -- Maryland ME -- Maine MI -- Michigan MN -- Minnesota MO -- Missouri MS -- Mississippi MT -- Montana NC -- North Carolina ND -- North Dakota NE -- Nebraska NH -- New Hampshire NJ -- New Jersey NM -- New Mexico NV -- Nevada NY -- New York OH -- Ohio OK -- Oklahoma OR -- Oregon PA -- Pennsylvania PR -- Puerto Rico RI -- Rhode Island SC -- South Carolina SD -- South Dakota TN -- Tennessee TX -- Texas UT -- Utah VA -- Virginia VI -- Virgin Islands VT -- Vermont WA -- Washington WI -- Wisconsin WV -- West Virginia WY -- Wyoming
Zip:
Day Phone:
Night Phone:
Cell Phone:
Email:
Website:
Blog:
Working Title:

1. What is your book title and focus.

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2. Who is your main target reader (be specific-not just moms or everyone)?

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3. What are the benefits of the book for readers?

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4. What are your marketing strengths (i.e. speaking, media, social networking, article writing)?

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5. What experience do you have in speaking, media, and articles?

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6. What image do you associate with your book concept?

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