Role Model Reading Program Application

2025 - 2026 School Year Signup

Please submit this form to get set up for book shipments. At end of the year, you will receive a survey to summarize your efforts.

Who is coordinating your reading program?

Where are your readings? (List Elementary Schools)

Number of reading visits you will have with EACH 2nd grader:

If visiting more than 1 time with each 2nd grader, please indicate how many Hog Mollies titles you will need.

Please enter an answer.

Total number of 2nd graders being read to for the school year. (Approximately):

Please enter an answer.

Please list your anticipated reading visit date(s) if already scheduled:

Who are your reading role models?

Name of Organization, High School, or College/University

Please enter a valid program name.

Type

Please select a valid type.

Main Address

Please enter a valid address.

County

Please enter a valid county.

City

Please enter a valid city.

State

Please select a valid state.

Zip

Please enter a valid zip code.

Total number of reading role models for the school year. (Approximately):

Please enter an answer.

How many sports teams will be participating?

Please list the specific sports participating. (Rowing, cheerleading, volleyball, etc.):

based on above answer

Additional Information

Where would you like your books shipped to?

Attention (Optional)

Attention Line 2 (Optional)

Shipping Address

Please enter a valid address.

Address 2

City

Please enter a valid city.

State

Please select a valid state.

Zip

Please enter a valid zip code.

Same as Above

How did you hear about us?

Please enter a valid answer.

Please share your social media handles so we can follow your team and school.

Be sure to follow us social media too!