Program Request Form - Read with Malcolm

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Email *

School Name: *

School Address (Please include city, state & zip): *

Principal's Name: *

Principal's Phone Number: *

Primary Contact: *

Primary Contact Cell Phone: *

Primary Contact Email Address: *

Number of Students: *

Number of Teachers: *

Grade Levels: *

Number of Books Requested: *

Program Options: *

READing Rally

Virtual READing Rally

Early Learning READing Initiative

READer to Leader (Middle and High School)

Required

What overall goal would you like to accomplish by bringing our program to your school? *

Target program date: *

Currently accepting Fall 2025 and Spring 2026 program date requests.

YYYY

Book Options (Please select one book to be used with your program): *

My Very Favorite Book in the Whole Wide World: Meet Henley, an all-around good kid, who hates to read. When he's supposed to be reading, he would rather do anything else. But one day, he gets the scariest homework assignment in the world: find your favorite book to share with the class tomorrow.

The Magician's Hat: David, the Magician, loves to perform magic - but his favorite trick is not pulling a rabbit out of a hat or finding quarters behind the ears of children. Instead, David loves the magical power of books, knowing that they can help students explore their dreams and develop creativity.

N/A (Reader to Leader Program)

Are you interested in applying for a Share the Magic Matching Grant (Must be a Title 1 school with 90% of the student body eligible to receive free/reduced lunch to be considered for grant funds.) *

Yes

Which major airport is closest to your school? (Please provide airport code if possible.) *

How did you hear about our programs? *

A copy of your responses will be emailed to the address you provided.

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