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  Mosaic   Musings
  Publications  
  Chapbook Order
  Form and Self Publishing Agreement  
  
  Please print out
  this agreement and fill-in all fields.  
  A Chapbook is an inexpensive, small booklet
  (5.5" X 8.5") containing works of popular literature such as poems,
  ballads, stories, essays, genealogies, lyrics, recipes or memoirs.   Mosaic Musings Publications offers
  quality, decorative and affordable chapbooks that can be custom designed to
  suit your needs.  Our chapbooks are
  saddle-stitched (staple-bound booklets) and may contain customized
  information about the author, an introduction, foreward,
  dedication, a table of contents and other special print requests.    
    
  Chapbook Packages  
  
  Please circle one of the following packages.  
  
  
   
    | 
     Quantity
    of Chapbooks 
    and 
    Complementary
    Copies 
     | 
    
     A Chapbook
    consisting of 16, 20, 24 or 28 pages of content (sold at Mosaic Musings for
    $5.00 each): 
     | 
    
     A Chapbook
    consisting of 32, 36, 40 or 44 pages of content (sold at Mosaic Musings for
    $7.00 each): 
     | 
    
   
    | 
     25 Copies (plus 1
    comp) 
     | 
    
     Nomadic Package 
    $175 
     | 
    
     Assyrian Package 
    $195 
     | 
    
   
    | 
     50 Copies (plus 2
    comp) 
     | 
    
     Egyptian Package 
    $275 
     | 
    
     Greek Package 
    $295 
     | 
    
   
    | 
     75 Copies (plus 3
    comp) 
     | 
    
     Trojan Package 
    $325 
     | 
    
     Roman Package 
    $345 
     | 
    
   
    | 
     100 Copies 
    (plus 5 comp) 
     | 
    
     Viking Package 
    $375 
     | 
    
     Supreme Package 
    $395 
     | 
    
   
   
    
  Layout and Design Choices 
  All our chapbooks feature 28 # gloss white interior
  pages and 67 # color covers.  Typeset is black ink.  As the author, you have the choice of color
  cover, cover design, font alignment (interior) and font text (from selected
  lists on our website). Your cover design includes one image free of charge.
  If you have a theme in mind for your cover image, but do not find our
  selections the perfect fit, we can provide other image options to you.
  Optional images (for the interior of your book) are $10 each. 
  Please
  specify your Chapbook design selections base on the choices listed on our
  website. 
  
  
   
    | 
     1.   
     | 
    
     Cover Design 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     2. 
     | 
    
     Cover Paper 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     3. 
     | 
    
     Cover Font  
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     4. 
     | 
    
     Images:Fractals 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     5. 
     | 
    
     Images:Naturals 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     6. 
     | 
    
     Images:Florals 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     7. 
     | 
    
     Images:World 
     | 
    
     ____________________________________ 
     | 
    
   
    | 
     8. 
     | 
    
     Text Font 
     | 
    
     ____________________________________ 
     | 
    
   
   
     
  Text Alignment 
    
  Circle one of
  the following: 
    
  
  
   
    | 
     Left 
     | 
    
     Centered 
     | 
    
     Justified  
    (short stories only) 
     | 
    
   
   
  Additional
  Instructions Regarding Design Choices: ______________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
     
    
  Custom Pages  
    
  
    
  
   
    | 
     U 
     | 
    
     Custom Feature 
     | 
    
     Instructions 
     | 
    
   
    | 
       
     | 
    
     First Title Page  
    (Chapbook title only) 
     | 
    
       
     | 
    
   
    | 
       
     | 
    
     Second Title Page 
    (Chapbook title and author) 
     | 
    
       
     | 
    
   
    | 
       
     | 
    
     Dedication 
     | 
    
       
     | 
    
   
    | 
       
     | 
    
     Description About the Author 
    (Introduction or Foreward) 
     | 
    
       
     | 
    
   
    | 
       
     | 
    
     Table of Contents  
     | 
    
       
     | 
    
   
  Additional
  Instructions Regarding Custom Pages: _______________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
  _______________________________________________________________________ 
     
     
    
  Books Subject/Category 
    
  Please check one or more of the following:
    
  Poetry: _______   Short Stories:
  _______   Geneology: _______   Recipies: _______ 
    
  Memoir: _______   Educational:
  _______   Children's Theme:_______  
  Other: _______  
    
    
    
  Manuscript Format
    
  Please select one of the
  following:
    
  MS Word: _______   Word Perfect:
  _______   Rich Text: _______   Other: _______ 
    
  * At this time, we cannot accept MAC files. Our preferred
  method is MS Word, NotePad, WordPad or RTF. 
     
  Back Cover Printing
    
  If you prefer to sell your Chapbook at a different price
  (other than the prices quoted in the Mosaic Musings website store), please
  mark the section below. Note – Mosaic Musings sells each Chapbook consisting
  of 16 to 28 pages of content for only $5.00 and Chapbooks consisting of 32 to
  44 pages of content for $7.00 on its website, regardless of what price you
  quote in this section. 
    
  Please select one of the
  following:
    
  ________ Print the price ($5.00 or $7.00) on the back
  cover. 
    
  ________ Do not print the price
  of my Chapbook on the back cover. 
    
  ________ Print the price of $_________ on the back cover
  of my Chapbook. 
    
    
  Payment Method
    
  Please select one of the
  following:
    
  Money Order: _______   Check (U.S.
  only): _______   Cash: _______   PayPal: _______ 
    
  *All checks should be made out to: "Mosaic Musings,
  LLC".  Any cash payments provided
  are submitted at your own risk.  All
  payments must be in the U.S. Dollars. Any bounced/returned checks will be
  subjected to a $20.00 fee. 
     
     
  Chapbook Fee Calculation Sheet
    
  Please calculate the
  payment total below. 
    
  
   
    | 
     Description 
     | 
    
     Price 
     | 
    
     Subtotal 
     | 
    
   
    | 
    
     | 
    
     See Pricing Structure 
     | 
    
     $________  
     | 
    
   
    | 
     Color Printing – Chapbook Cover 
     | 
    
     FREE from website designs or $50.00 if own design 
     | 
    
     $________  
     | 
    
   
    | 
     Color Printing – Inside Chapbook  
     | 
    
     $100.00  
     | 
    
     $________  
     | 
    
   
    | 
     Optional Images 
     | 
    
     $10.00 per photo/drawing 
     | 
    
     $________  
     | 
    
   
    | 
     Handwritten Manuscripts Typing 
     | 
    
     $75.00 
     | 
    
     $________  
     | 
    
   
    | 
     Corrections exceeding the 15 error on proof copy
    requirements 
     | 
    
     $0.50 each 
     | 
    
     $________  
     | 
    
   
    | 
     ISBN Number 
     | 
    
     $30.00 
     | 
    
     $________  
     | 
    
   
    | 
     Return disks, photos, artwork 
     | 
    
     $3.00 
     | 
    
     $________  
     | 
    
   
    | 
     Barcode on back cover  
     | 
    
     FREE with publication 
     | 
    
     $________  
     | 
    
   
    | 
     Shipping  
     | 
    
     FREE with publication 
     | 
    
     $________  
     | 
    
   
    | 
       
     | 
    
    
                 Total Amount Due 
     | 
    
     $________  
     | 
    
   
    
  Time-Frame
    
  We generally provide a turn around time of 3-4 weeks once
  the contract, payment and content are received. At this time, we will send
  one proof copy and allow for a maximum of fifteen (15) corrections from this
  proof.  Once the proof has been accepted, there are additional fees for
  further changes. Once the final editing is complete, the shipment would be
  sent free of charge.  
    
  Additional Terms and Conditions
    
  
    
  Warranties:  
  You represent and warrant to Mosaic Musings that all
  poetry, artwork, and other materials (the “Content”) submitted for your
  Chapbook is your own work and that you do not infringe or violate the rights
  of anyone else and that you are the sole owner to the rights to the Content.
  You understand that it is your sole responsibility to obtain any copyright
  permission necessary to publish the Content. You also warrant that the
  Content does not libel anyone, invade anyone’s privacy, copyright, patent, or
  trade secret rights, or otherwise violate applicable law.  You agree to indemnify Mosaic Musings and
  its affiliates, directors, officers, consultants and employees and hold them
  harmless from any and all claims and expenses, including attorney's fees,
  arising from your use of this service against any claim or action alleging
  facts, which, if true, constitute a breach of any of the foregoing
  warranties. 
    
  Multiple Authors:  
  This form is to be filled-out by the Author. 
  If there is more than one author of the Content, the word “you”
  includes all authors jointly and severally. One Author may fill-out the form
  for all, but by doing so he/she is attesting that each Author has approved
  this agreement and has agreed to be bound by it.  
    
  Further Conditions: 
  You understand Mosaic Musings Publications may reject your
  Chapbook submission for any reason, and that Mosaic Musings is not
  responsible for lost or damaged orders during the shipping process or any
  errors in the Chapbook.  You also
  understand that your Content (e.g. disks, photos, or artwork) will not be
  returned unless you have included shipping and handling costs with your
  initial payment.   
  You are fully aware that should you not want to
  proceed with publishing your Content with Mosaic Musings after you send in
  your manuscript and/or after receipt of your proof copies, you are not
  entitled to a full refund. You will be refunded any payment(s) made less a
  $150.00 setup fee included within the Chapbook pricing (see Above Chapbook
  Pricing Structure Chart); You further agree that once the PROOF copy has been
  returned to Mosaic Musings by you, the order is NON-REFUNDABLE.    
    
  You understand that should you change your mind after
  sending in your Content, you are not entitled to a full refund of the
  contract price.  You will be refunded your payment less a $150.00 set up
  fee.   
    
    
  Royalty Option 
    
  By selecting the following royalty option, you grant
  Mosaic Musings permission to sell your Chapbook on its website.  Any sales for your Chapbook from the Mosaic
  Musings site entitle you to a 25% royalty from the net profits of the
  sale of each copy. You will receive these royalty payments quarterly.  Mosaic Musings has the right not to sell
  your Chapbook on its site, and it has the right remove your Chapbook from its
  site at anytime.  
    
  If you choose not to select the above Royalty option,
  Mosaic Musings will not sell or advertise your Chapbook on its website. 
    
  Please
  check one of the following: 
    
  
   
    | 
     U 
     | 
    
       
     | 
    
   
    | 
     ________ 
     | 
    
     Yes, I would like Mosaic Musings to sell my Chapbook on
    its website, and I will receive 25% royalty from the net profits of
    the sale of each copy.  
     | 
    
   
    | 
     ________ 
     | 
    
     No, I do not want Mosaic Musings
    to sell my Chapbook on its website. 
     | 
    
   
    
  
  
  
  
  
  
  Information About the Author(s)
  
  First Author’s
  Name: ______________________________________________________    
    
  Phone: (   
  ) _______________________  Fax: (    ) ______________________________ 
    
  Address:
  ________________________________________________________________ 
    
  City: __________________________   State:
  ___________________   Zip:___________ 
    
  Country: _________________________ 
  Pen name:______________________________ 
    
  Email Address:
  ___________________________________________________________ 
  
  Second Author’s
  Name: ____________________________________________________    
    
  Phone: (   
  ) _______________________  Fax: (    ) ______________________________ 
    
  Address:
  ________________________________________________________________ 
    
  City: __________________________   State:
  ___________________   Zip:___________ 
    
  Country: _________________________ 
  Pen name:______________________________ 
    
  Email Address:
  ___________________________________________________________ 
   . 
  Third
  Author’s Name:
  ______________________________________________________    
    
  Phone: (   
  ) _______________________  Fax: (    ) ______________________________ 
    
  Address:
  ________________________________________________________________ 
    
  City: __________________________   State:
  ___________________   Zip:___________ 
    
  Country: _________________________ 
  Pen name:______________________________ 
    
  Email Address:
  ___________________________________________________________ 
   
   
   
   
  
    
    
  Title of Chapbook:
  _____________________________________________________ 
    
  Signing Author's Name:
  __________________________________________________ 
    
    
  Author's Signature:
  _____________________________________   Date: ___________ 
    
    
   
  
  Chapbook
  Submission Checklist 
  
   - Print
       and fill out the Chapbook Order and Self Publishing Agreement 
 
   - Gather
       all Content (photos or drawings/artwork) you wish to include in the
       Chapbook 
 
   - Place
       all materials in a padded envelope or box (disks, photos, artwork,
       etc.). 
 
   - Email
       manuscript and any images directly to lkanter@mosaicmusings.net. 
 
   - Enclose
       payment for full amount to publish your chapbook (unless paying by
       PayPal). 
 
   - Send
       package to: 
 
   
  
  
  
  
    
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