Sign Up for Summer Reading!
** PRIVACY & CONFIDENTIALITY NOTICE **

This Information is for INTERNAL Library use ONLY. We will not share your information or use it for any other use than Summer Reading Program communications, and it will be permanently deleted following the conclusion of the 2017 Family Summer Reading Program. For more information on how American libraries are advocating for your right to privacy, visit http://www.ala.org/advocacy/privacyconfidentiality.

First Name
Your answer
Middle Initial
Your answer
Last Name
Your answer
Please enter any prefix (Mr./Mrs./Etc.) or suffix (Jr./Sr./III/Etc.) you would like printed on your final certificate:
Your answer
Mailing Address (including city, state, and zip code)
Your answer
Phone Number
Your answer
Email Address
Your answer
Age
Your answer
School (enter "NA" if an adult or if child is not currently enrolled)
Your answer
Upcoming Grade in the 2017-2018 School Year (enter "NA" if an adult or if child is not currently enrolled)
Your answer
Parent (enter "NA" if 18 or older)
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms