Fill out the information below to register your child for Little Listeners on Wednesday, May 22, 2019 at 9:30 am. This program is appropriate for children up to 23 months old.

Please use one registration form per child.

Registration is limited to Scotch Plains and Fanwood cardholders only.

Question Title

* 1. child's full name

Question Title

* 2. child's age (months)

Question Title

* 3. caregiver's name

Question Title

* 4. home library
** Please note that you MUST be a resident cardholder of Scotch Plains or Fanwood to register for this program

Question Title

* 5. library card barcode number

Question Title

* 6. telephone number
please use this format: 000-000-0000

Question Title

* 7. email address

T