Review Copy Program: Sign Up This sign-up form and agreement takes approximately five minutes to complete. Name* First Last Please select the formats you wish to receive:*In what format do you prefer to receive your review copy of LEAP: The Case for The Country of Earth?You can receive up to one copy of each. However, we ask that you please do not share these copies with others. Instead, send them back here--https://LEAP.Earth--to sign up to receive their own review copy. Thank you! Digital PDF (for Kindle and other eBook readers) Digital Audio (mp3 format, suitable for iTunes and other audio players) Paperback How did you hear about LEAP?Check all that apply.*You must check at least one box. At a conference, training program, class or similar event At a fair, festival or similar event Through a web search Through a Social Media post (Facebook, Twitter, etc.) Through a personal connection (friend, family member, colleague, someone I recently met, etc.) Other At a conference, training program, class or similar event...*Which event?Climate Reality Leadership Corps Training [LA, August 2018]Holistic Expo [January 2019]Conscious Life Expo [February 2019]At a fair, festival or similar event...Which event?Reno Spirit Fest [March 2019]Through a Social Media post (Facebook, Twitter, etc.)...*Do you remember which social media platform?FacebookYouTubeInstagramTwitterRedditPinterestTumblrOtherSocial Media Platform: Other*Please enter the name of the other social media platform. Thank you.How did you hear about LEAP: Other*Please describe how else you learned about LEAP:Who introduced you to LEAP?If you can recall, please enter the name(s) of the person(s) who introduced you to LEAP, if you know them or can remember their name(s). Thank you.Markus Thorndike, the author of LEAPReview Copy Program Terms of AgreementUnless noted otherwise, these agreements are required for your participation in the program. Please read through each agreement, as you check it off. Thank you!Agreement to Purchase LEAP on AmazonBy checking the box below you are agreeing to purchase one or more copies of LEAP: The Case for The Country of Earth between now and Earth Day, April 22, 2019. LEAP will be available for pre-sale on Amazon beginning January 22, 2019. Yes, I agree to purchase at least one copy of LEAP: The Case for The Country of Earth on Amazon prior to and/or on the very first day that LEAP is released to the public. Agreement to Submit an Honest Review on Amazon on Earth Day, April 22, 2019By checking the box below you are agreeing to submit an honest review of LEAP on the day it is formally published and released to the public: Earth Day, April 22, 2019. Yes, I agree to provide an honest review of LEAP: The Case for The Country of Earth on Amazon on the same day that LEAP is released to the public. Agreement to Stay In Touch, and Receive UpdatesBy checking the box below you are agreeing to stay in touch with us, and to receive updates from us.Specifically, you agree to let us know when you have purchased your copy on Amazon, and when you have submitted your honest review.You also are agreeing to receive updates from us, approximately once per month, until LEAP is formally published and released to the public on Earth Day, April 22, 2019. I agree to stay in touch with you. I agree to let you know when I have made my purchase of LEAP on Amazon, and when I have submitted my honest review of LEAP on Amazon. I also agree to receive email updates from you over the course of the review copy program. [Optional] Program Cost: Offset Donation RequestedOnce you submit your request to join the LEAP Review Copy Program, you will be asked to make a small donation to help offset the costs of providing these review copies to you and your fellow citizens free of charge.The requested donation is $6 for Digital PDF or Audio, and $18 for Paperback--which is just about double the amount of the estimated cost we incur to send you your review cop(ies).If at least half of all program participants donate at this level, we can sustain the program and continue offering it to other citizens who wish to receive their own copies of LEAP. If you are able to contribute, we thank you! Yes, I plan to make a donation, to offset your costs. Thank you! Thank You!You will be taken to a donation page once you have completed signing up for the program. Thank you!!!How to Contact YouIn order to send you a review copy of LEAP, we will need you to verify your email address and (for paperback copies) also provide us with your full mailing address, at a minimum. We would also like to stay in touch with you via text.We respect your privacy, and will never share the personal information you provide below with anyone else.Email Address*You will be sent an email message asking you to click a link that will verify your email address. Until you confirm your email and verify your account, we will not be able to send you a review copy of LEAP. The verification link will be valid for 24 hours. Enter Email Confirm Email [Optional] Textable Phone NumberThis field is optional. If you enter a number here, we will send you a text message asking if you wish to opt in to receive text messages about LEAP.Physical Mailing Address, including Address Verification*We must have a complete and accurate mailing address from you in order to send you a review copy of LEAP in paperback form.In addition, due to the costs and effort involved in sending you a paperback review copy, we will in many cases be sending out a physical address verification letter to you prior to sending out your review copy--so that we can ensure that you did indeed request this copy of LEAP from us.When you receive this verification letter from us, you will then need to take a picture of yourself holding this letter, and email this picture to us at the email address provided to you in the letter. Alternatively, you can also physically mail the letter back to us.If you agree to participating in this address verification process, so that you can receive a paperback review copy of LEAP, please enter your physical mailing address below. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Sign and Verify You Are HumanThis program is offered on the "honor system." We are counting on you to use this program respectfully in the ways it is intended and to comply with the terms of the program. By signing below, you are agreeing to do so. Thank you.DIGITAL SIGNATURE*Please enter your full name (as you entered above). Your entering your name here constitutes your signed agreement to the Terms of the Review Copy Program..And finally, please verify that you are human...EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.