2021 Adult Winter Reading Program
January 11- March 13 Ages 18 and older.
Join the Winter Reading Program and receive a participation prize. Read 5 books to be entered into our grand prize drawing. Each book you read is worth one ticket.
Please write down each book you have read. One form per participant please.
* Required
Last Name
*
Your answer
First Name
*
Your answer
Phone Number
*
Your answer
Email address (if none put "none")
*
Your answer
I have read (title and author) (1 ticket for each book read) NA if none
*
Your answer
I have read (title and author) (1 ticket for each book read) NA if none
*
Your answer
I have read (title and author) (1 ticket for each book read) NA if none
*
Your answer
I have read (title and author) (1 ticket for each book read) NA if none
*
Your answer
I have read (title and author) (1 ticket for each book read) NA if none
*
Your answer
Which Prize do you want your tickets to go towards? 5 Ticket Max
*
0
1
2
3
4
5
Movie Bundle
Holiday Book Bundle 1
Holiday Book Bundle 2
Mug Cakes
Hat/Scarf/Gloves
0
1
2
3
4
5
Movie Bundle
Holiday Book Bundle 1
Holiday Book Bundle 2
Mug Cakes
Hat/Scarf/Gloves
Bonus Ticket (Write a review on a book you've read)
Your answer
Bonus Ticket (Write a review on a book you've read)
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Library.
Report Abuse
Forms