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Name*

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Eligibility Requirements (check all that apply) *

Eligibility 1

If you are an author or illustrator you must have at least one book published or under contract that meets ALL of these criteria. If you are an editor you must currently work for a publishing house that meets ALL of these criteria, or if you are currently an editor whose prior work history matches these criteria, you are also eligible (and please check all five boxes below).

1. Your publisher pays authors and illustrators an advance against royalties

Eligibility 2

2. Publishes books in print format

Eligibility 3

3. Has editorial, marketing and distribution staff

Eligibility 4

4. Has at least one prior list in print

Eligibility 5

5. Has multiple authors / illustrators

I certify that I have written, illustrated or edited approximately this number of books published or under contract that meet all the above criteria:*

Title, Publisher and Date of most recent or best known book:*