"Screen Smart Sam" Free Books for Parent Engagement Application
Thank you for your interest in receiving free copies of the children's book "Screen Smart Sam" to distribute/gift to parents to assist in supporting digital citizenship education efforts your community! A big thank you to www.OurPact.org and Honda of SoCal for their support in making this possible!

Please complete the following form so we may consider your application. We will be matching requests with local or national sponsors. Currently we are prioritizing requests for teacher applicants in Southern California and the USA, maximum of one class set per school year per teacher to send home as a gift to parents so it may be read multiple times at home, ideally with an activity or guidance from teacher about how to best utilize the tips in the book. We can assist in helping teachers craft an outreach letter or activities with screen guidance to maximize the benefits about learning healthy screen routines!
Name *
School or Organization *
Grade *
School District *
Full Address of Your School *
Email address *
Do you need a preview PDF copy of the book? *
How many copies would you need to send one home to every family in your classroom? *
WHAT DATE WILL YOU GIVE THE BOOKS TO FAMILIES? (this school year, next...approximate is fine if in the future)
When do you anticipate distributing the book? Ideally incorporating it into a lesson or week about digital citizenship... this school year or next or a specific date? This helps us spread out our donations if it is not immediately needed or won't be used until a future date we can approve your request and ship the books later. A general month/year is fine unless you have specific "Screen Free Week" or other event planned or start of school year or send home with students at the end of the school year to remind them about importance of limiting screen time over summertime!
Would you be willing to take some photos of the donation to share with sponsors and social media? Either picture with you with the books, books in your classroom, back view of children receiving the book, or consenting parent & child receiving the book? *
We want to acknowledge the generous donation made possible by various generous sponsors by placing a sticker on the inside of the book acknowledging the specific sponsor for your book allotment. SOME books MAY need your help placing the provided stickers on the inside of the book before you give them to students to take home to parents. Can you help us with that? We will provide the pre-printed stickers. Some sponsored copies have donated by pre-printed :)
Clear selection
Are you interested in any of the following (check all that apply) *
Does your school have a PTA or PTO group? If so what is the email for the contact person for the organization? Many schools do not have parent fundraising organization. We would like to give your school's PTO the opportunity to sponsor the books so more may be donated to schools without supplemental funding available. *
Anything else we should know about you, your class or students?! Thank you for your interest in receiving and distributing this great resource to help kids and families create healthy technology habits! *
How did you hear about this donation opportunity?
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