Gregath Company, Incorporated
 PO BOX 505, Wyandotte, OK 74370, USA 
 Phone/FAX 01-918-542-4148 | Toll Free (inside the USA) 1-800-955-5232
 Phone Hours: 9-4 CT/M-FEmails generally answered within one working day


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Advertise Reprinted Book Contract
Reprint/Reproduction of Previously Published Material
Please Print & Mail
Click here if your book is NOT a reprint. | Click here if you want to sell an item (DVD, Map, subscription, etc.)
To program description

** Required information - 
If you do not fill in these items, the contract is invalid.

 I am
**(check one and fill out completely)

the Copyright holder (circle A or B) and
  A - am sending a copy of my Copyright form for your files.
 
B - holding an implied Copyright, consider this my statement of Copyright for your files.
not the Copyright holder and am sending a copy of my Copyright release, giving me permission to publish, for your files.

and authorize Gregath Company, Inc. to advertise and sell:

**_____________________________________________________________________________________

**by__________________________________________________________________________________

Gregath Company, Incorporated will forward the following 
**(check one and fill out completely)

payment via check to:

Name: _________________________________________________________________________

Address: _______________________________________________________________________

City/State/Zip: _________________________________________________________________

Please include pre-addressed mailing label (choose one) - YES   NO

delivery mailing information and electronic payment via PayPal email provide 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)
plus a shipping allowance which will be from $2-6 dollars per book.

 I agree to mail all orders by **(check one and fill out)

Post Office via _____________________________________________ (type/class)

Other Carrier  _____________________________________________ (specify)

to the designated customer within 10 days of receipt of forwarded order.

I further agree to notify Gregath Company, Incorporated when my supply of books is sold down to ten (10) books and/or there is any other change in the status of the book which may effect the ability of filling these orders.

 

_______________________________________________________________________________________

**Signature                                                                                                            **Date

Phone Number ______________________________________________________________

Email Address: ________________________________________________________________

**Subscribed and sworn before me,

this _________________ day of _________________________, 20__.

 ____________________________________________________________________

(If Notary Public) My commission expires

Description of book for Advertisement (optional):

Size _______

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.

Please Print & Mail
Click here if your book is NOT a reprint. | Click here if you want to sell an item (DVD, Map, subscription, etc.)
To program description

Thank you for your interest.

This Page Last Updated: April 13, 2012

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