First Library™ Registration Form
First Library’s™ mission is to promote early childhood literacy for children of first time mothers through book ownership, educational support and library patronage.

First Library’s incentive and reward program offers first time mothers the opportunity to earn points through various free reading related activities to shop for additional books at our First Library Book Shop™.

Previous participation in a free monthly book program is a prerequisite for participation in the First Library program.

Please register to participate in this additional program.

Enjoy reading to your child!

Email address *
Last Name *
Your answer
First Name *
Your answer
Child’s Last Name *
Your answer
Child’s First Name *
Your answer
Child’s DOB *
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DD
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YYYY
Child’s Gender *
Street Address *
Your answer
Apt. #
Your answer
Town *
Your answer
State *
Your answer
Zip code *
Your answer
Telephone number *
Your answer
This is my first child. *
Required
My child is under one year old. *
Required
I am able to read to my child every day. *
Required
I am able to maintain local library patronage. *
Required
I am able to commit to the First Library program for three years. *
Required
I am currently enrolled in a free monthly book program. *
Name of free monthly book program. *
Your answer
First Library uses data and school test scores to evaluate the program. By enrolling your child in the First Library program, you agree to the inclusion of your child’s data in our data collection. This information is provided and used anonymously. *
Required
Signature (please print) *
Your answer
Date *
MM
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YYYY
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