Should You Write a Book Questionnaire Personal Contact Information Question Title * 1. It's a question many survivors of dire circumstances ask; especially if someone has said, "You should write a book." Even though the seed has been planted, you may not yet be ready to write a book, or, if you are, know where to begin. By completing this questionnaire, and in as much detail as possible, you and I will explore your next steps. If you have any questions that aren't covered, there is a place at the end to ask them or to share any comments you may have. Enter your full name, postal address, and phone number. I value your privacy. This information will not be shared or sold with anyone. Name: * Company: Address: * Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: * Country: Email Address: * Phone Number: * Next