2022 Summer Reading Program Registration Form

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2022 Summer Reading Program Registration Form

Please fill out this form for each person who receives a log for the 2022 Summer Reading Program.

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* Indicates required question

Library Branch: *

Choose

Southwest

Northside

Simmons

Uptown

Bookmobile

Beanstack (only select once patron completes the SRP on Beanstack)

First *

Your answer

Last *

Your answer

Age *

Choose

<1 year

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

Adult

Phone Number (with Area Code) *

Your answer

Which Log Did The Patron Receive? *

Kids 0-5

Kids 5-12

Option 5

Teens 12-19

Adult

Submit

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