Read to Rover Application Form
Have fun, make a new friend, and improve your reading. Students in grades 1-5 can read to a certified therapy dog for 25 minutes each week in November. They can bring their own reading materials or a librarian will help select materials at the library. Any questions, please call (262) 375-5315 ext. Youth Services.
Email *
Your answer
Child's First & Last Name *
Your answer
Age *
Your answer
Phone *
Your answer
Grade *
School *
Your answer
Does your child have any special needs? *
Learning, emotional, or physical
Does your child have any fears or apprehension around animals, especially dogs? *
Your answer
Does your family have a dog at home? *
Your answer
Does your child have any known allergies? *
Your answer
Please provide any additional information the reading therapy dog team may need to know.
Your answer
Please indicate time preferences below
Please select your time preference. Sessions are every Monday in November (Nov. 4, 11, 18, & 25). You will be sent a schedule by email. You may only sign up for one time slot a day.
November 4
November 11
November 18
November 25
4:00-4:25 p.m.
5:00-5:25 p.m.
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Type your first and last name
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