Summer Reading Program Enrollment 2015

You may enroll up to three people using this survey.

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* 1. What is your name?

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* 2. Contact information

phone number

email that you check regularly

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* 3. Check the button for the program you are enrolling in.

Preschool (ages 6 mo. to Kindergarten)

Completed Kindergarten through 5th grade

Teen program (completed 6th grade or above)

Adult program

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* 4. Enroll a second person in the Summer Reading Program

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* 5. Contact information (if different from the 1st person)

Phone number

Email that is checked regularly

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* 6. Check the button for the program you are enrolling in.

Preschool (ages 6 mo. to Kindergarten)

Completed Kindergarten through 5th grade

Teen program (completed 6th grade or above)

Adult program

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* 7. Enroll a third person in the Summer Reading Program

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* 8. Contact information (if different from the 1st person)

Phone number

Email that is checked regularly

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* 9. Check the button for the program you are enrolling in.

Preschool (ages 6 mo. to Kindergarten)

Completed Kindergarten through 5th grade

Teen program (completed 6th grade or above)

Adult program

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* 10. I will pick up my Summer Reading Program materials

Between May 15 & May 21

At the Summer Reading Program Kick-off event 10 am Fri. May 22

May 23 or later