Online Registration Form.

Publisher's / Company's Name: *

Self-publishers - Enter your name. Publishing houses enter the name of the company

Name - Contact *

First

Last

Full name of contact for the publisher

Telephone Number - Contact *

10 digits e.g. 8763220000. include the area code. Do not include ( ) or -

Address - Publisher: *

Local Street address of the publisher is required. Avoid entering only the P.O. Box

Telephone:

10 digits e.g. 8763220000. include the area code. Do not include ( ) or -

Cell phone:

10 digits e.g. 8763220000. include the area code. Do not include ( ) or -

Email *

Email

Confirm Email

Enter your electronic mailing address.

Fax:

Website:

Year started publishing *

Enter the year of your first publication

Are you a subsidiary of another company? *

• Yes
• No

If yes, provide name, address and ISBN Registrant Element:

The number of ISBNs required, if unknown, use an approximate output (see below*): *

• Registration Fee - US$20
• Single ISBN - US$20
• Two ISBN - US$40
• Block of 10 ISBNs - US$50
• Block of 100 ISBNs - US$300
• Block of 1,000 ISBNs - US$700
• Block of 10,000 ISBNs - US$1,500

Publishers who are already registered are only required to pay the processing fee. * N.B Publishers should state an approximate output in order to be allocated specific ISBN blocks, i.e. 1-3 titles - block of 10 ISBNs, 4-70 titles - block of 100 ISBNs, more than 70 titles - block of 1000 ISBNs. Publishers may also apply for a single ISBN from an element range reserved for occasional publishers. The elements does NOT identify any particular publisher, and cannot be claimed to be owned by any one publisher.

Number of titles per year *

Enter the number of ISBNs required. If uncertain, select an approximate output (see guide below)

Please indicate what you're paying for *

• Registration
• Purchase
• Registration & Purchase

* If you are an existing publisher with us, there is no need to make another registration payment.

Choose your preferred payment method *

• Online Payment
• International Bank Draft
• Wire Transfer

* If you are an existing publisher with us, there is no need to make another registration payment.

By checking this box you confirm that the information you entered is valid *

• I confirm the Information is accurate

I certify that the information submitted in this application is true and correct to the best of my knowledge.

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NLJ ISBN Digital Web Forms

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