Ready to Read request

Ready to Read request
Thank you for your interest in our program. Please give us a little more information and we will reach out to you.
Name*

First nameLast name
Library barcode (optional)
Email
Phone number*
Phone number*
Preferred Library location*
ZIP code*
How many children do you have?*
Name of child 1*
Birthday of child 1*

MonthDayYear
Date
Grade of child 1*
Please fill in for children aged 4 years or older
Name of child 2*
Birthday of child 2*

MonthDayYear
Date
Grade of child 2*
Please fill in for children aged 4 years or older
Name of child 3*
Birthday of child 3*

MonthDayYear
Date
Grade of child 3*
Please fill in for children aged 4 years or older
Name of child 4*
Birthday of child 4*

MonthDayYear
Date
Grade of child 4*
Please fill in for children aged 4 years or older
Name of child 5*
Birthday of child 5*

MonthDayYear
Date
Grade of child 5*
Please fill in for children aged 4 years or older
Names, ages, & birthdays of children*
Child 1: Child 2: Child 3: Child 4: Child 5: Child 6:For example: 1, 2, 5, 7, 9 ,11
Language(s) spoken in your home

ArabicASLEnglishMandarinSpanishOther
Interested in*

Preschool training (for caregivers of children birth to age 5)Countdown to Kindergarten training (for caregivers of children soon to be entering kindergarten)Kindergarten through 3rd grade reading support (for caregivers of children in Kindergarten, 1st grade, 2nd grade, or 3rd grade)Hosting our group at your event
Please provide more details about your event:*
Preferred method of meeting:*

PhoneOnline (Zoom)In Person at a Library location
Preferred time to meet:*

MorningAfternoonEvening
Preferred day to meet:*

MondaysTuesdaysWednesdaysThursdaysFridays
Is there any additional information that will help us schedule your Ready to Read experience?
Please describe any support or accommodations we may provide so you may participate in a Ready to Read programs.
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