Program Profile Form

2023 - 2024 School Year Signup

Please use the form below to sign up. Fields marked with * are required.

New Program Information

Program Name (School District / Main School Name)

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.

Contacts

Address for Book Shipments

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.

Schools

Additional Program Information

High School/College providing positive role models to read with 2nd grade students:

Please enter an answer.

What teams/student athletes will be involved in your reading events:

Please enter an answer.

How many books will you need for this school year:

This can be a projection up to 1,000 to be shipped throughout the current school year without prior approval.

Total Number Kids

Number Visits