KPL Adult Summer Reading Program Log
Fill out this form after reading books or completing Library activities July 1st through August 15. Fill out a new form for each entry, or use the same form for multiple entries. Each book read or activity completed counts as an entry to win. Turn in at least 1 entry per week to be entered to win a weekly prize-these consist of books & Library swag! Remember to choose which grand prizes you would like your entries to go toward. Contact Merissa with questions at reference@keokuk.lib.ia.us
Participant's First & Last Name *
Participant's Phone Number (to contact you if you win a prize!) *
What town do you live in? *
Book Title and Author (You can add multiple books on one form if you'd like!)
Library Activities Completed:
Library Events Attended
Grand Prizes are listed below. Please check all prizes that you are interested in.
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