Advance Countdown Widget Order Form

Your Name (required)

Your Email (required)

Your Website

Book Information:

Please provide me with as much information as you can about the Book that you're requesting a countdown timer for. 🙂

Book Title (required)

Author (required)

Release Date (required)

Book Synopsis:
Enter Synopsis here..

Goodreads Link

Pre-Order Links (if available):

Amazon

iTunes

Barnes & Noble

Kobo

Google

The Book Depository

Any other retailers? Smashwords, Indiebound, etc?

Book Cover Art
Please must be at least 250px wide (but would prefer as high-res as possible)

Anything else?