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* Indicates required question
Name of Organization
*
Your answer
Please check the box that best describes your organization type (check one):
*
Faith-Based Organization
Nonprofit/Community-Based Organization
School District or School
Charter School
City/State/Other Municipality
Institution of Higher Learning
Other:
Required
Contact Information
Address
*
Street, City, State and Zip Code
Your answer
Contact Person
*
Your answer
Title
Your answer
Email
*
Your answer
Number of Books Requested:
*
acceptable answers in whole numbers only
Your answer
Information about your organization:
*
Your answer
What is the nature of your work with children?
*
Your answer
How long has your organization been working working with children?
*
Your answer
How many children will you serve in 2014?
*
Your answer
Please provide a grade level breakdown for the children that you expect to serve at your site(s). The breakdown provided should be based on children’s grade levels for the 2013-14 school year:
Pre-Kindergarten
Your answer
Kindergarten - 2nd Grade
Your answer
3rd Grade - 5th Grade
Your answer
Do you have opportunities for volunteers to support your program? If so, please describe those opportunities below.
Your answer
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