To: register@questhavenpublishing.com
Subject: Quest Haven Publishing Company Registration

Publishing Company's Name				[required-PublishingCompany]
Contact Name							[required-Contact]
Contact E-mail							[required-E-mail]
Address									[Address]
Phone									[Phone]
Fax										[Fax]
Web Site								[WebSite]
Preferred Method of Contact for orders	[PreferredMethod]
Number of Works Intended				[Numberworks]
Self-publishing Composer				[Self-publish]
Need contact regarding graphics			[Logo]
Comments								[Comments]