Have a location/organization in mind that you think has what it takes? Share more info below!
* Required
Name of Potential Host Location/Organization:
*
Your answer
Address:
*
Your answer
Contact at Location/Organization
Name:
*
Your answer
Phone Number:
*
Your answer
Hours of Operation:
*
Your answer
Additional Information (Optional)
Tell us why you think this location/organization would be a great fit to host a free book vending machine.
Your answer
Describe the type of programming the location/organization provides (July-August)?
Your answer
How many children does the location/organization serve?
Your answer
Average number of children on site each day (July-August)?
Your answer
How many community events are hosted on site (July-August)?
Your answer
Submit
Never submit passwords through Google Forms.
Forms
This form was created inside of uPOP Media.
Terms of Service