Books to Go Application

This application is open to publicly-funded Idaho public libraries. Please fill out information for at least one partner. Scroll through survey to the end after you have filled in partner information.

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* 1. Please enter the following information:

Name of Public Library

Contact Name

Mailing address

City

State

Zip code

Phone

Email address

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* 2. I will be able to host an orientation session and/or Idaho Child Care Reads workshop to kick off the program in my community.

Yes

Not Sure

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* 3. I agree to collect evaluation data and implement the program for a minimum of three (3) years (barring extenuating circumstances) at all partner sites listed below.

Yes

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* 4. Partner #1

Organization Name

Approximate # of children at this site

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* 5. Type of organization:

Head Start/Even Start

Private Daycare

School District Developmental Preschool

Private Preschool

Other

Other (please specify)

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* 6. Ages of children served: (Check all that apply)

Birth to two years

Three to six years

Over six years

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* 7. I prefer bilingual or Spanish books and handouts for this site

Yes

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* 8. Partner #2

Organization Name

Approximate # of children at this site

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* 9. Type of organization:

Head Start/Even Start

Private Daycare

School District Developmental Preschool

Private Preschool

Other

Other (please specify)

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* 10. Ages of children served: (Check all that apply)

Birth to two years

Three to six years

Over six years

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* 11. I prefer bilingual or Spanish books and handouts for this site

Yes

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* 12. Partner #3

Organization Name

Approximate # of children at this site

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* 13. Type of organization:

Head Start/Even Start

Private Daycare

School District Developmental Preschool

Private Preschool

Other

Other (please specify)

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* 14. Ages of children served: (Check all that apply)

Birth to two years

Three to six years

Over six years

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* 15. I prefer bilingual or Spanish books and handouts for this site

Yes

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* 16. Partner #4

Organization Name

Approximate # of children at this site

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* 17. Type of organization:

Head Start/Even Start

Private Daycare

School District Developmental Preschool

Private Preschool

Other

Other (please specify)

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* 18. Ages of children served: (Check all that apply)

Birth to two years

Three to six years

Over six years

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* 19. I prefer bilingual or Spanish books and handouts for this site

Yes

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* 20. Partner #5

Organization Name

Approximate # of children at this site

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* 21. Type of organization:

Head Start/Even Start

Private Daycare

School District Developmental Preschool

Private Preschool

Other

Other (please specify)

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* 22. Ages of children served: (Check all that apply)

Birth to two years

Three to six years

Over six years

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* 23. I prefer bilingual or Spanish books and handouts for this site

Yes

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* 24. Once you click "done" below your report will be submitted. You will receive a confirmation email from an ICfL staff member within 2-3 working days. If you DO NOT receive this confirmation email, please first check your Spam folder, then contact Stephanie Bailey-White.
If you have more than five partners who are interested or have questions about the program, please let Stephanie know.

100% of survey complete.