indie bookstore profile form

First name

Last name

Name as you would like it published. This can be your full name, first name and last initial, just initials or Anonymous.

Telephone number

Email

Birthday

Month

Day

Year

Current school grade you are in.

Moonlit Books requires parental permission to publish reviews. Please provide your parent or legal guardian's name, email address and telephone number below so we can send them the parental permission form.

Please type or cut and paste your independent book store profile into the box below. Please include the name and location of the store.

Please add a photo of the inside or outside of the bookstore, if possible.

By clicking submit, you agree to having your name as designated, your bookstore review and photo (if submitted) published on moonlitbooks.org .