Magazine Publisher Inquiry Form


Personal Details

Name *

First

Last
Email *
Address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Number *

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Cell phone *

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How did you hear about this magazine opportunity? *

Financial Status

Do you own or rent your home?
If you own, what is the home's value?
If you rent, what is your monthly payment?
What is the amount of liquid capital ($US) you have to invest in your magazine? ($18K min. required) *

Employment/Education

Present Occupation *
Position *
How long (months)? *
Highest Level of Education Completed

Relevant Education

Describe the type(s) of business(es) you have owned or operated in the past. *
Do you have any writing or sales experience? *
Why are you interested in becoming a regional magazine publisher? *
In that geographical city or state are you interested in? *
How soon do you want to start publishing your magazine? *
Do you personally own a dog?
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