Vernon Reads! Enrollment Form

Vernon Reads! Virtual Library Program Enrollment Form
Family members may complete one enrollment form if signing on behalf of child(ren) in household. Adult family members 18 and over must complete a separate enrollment form.
Vernon Resident Name*

First Last
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
For Kids

If enrolling for child(ren) in household, please complete the section below.
I would like to:

Request an Amazon Kindle Kids E-Reader for child(ren), age 2-12, and a 6-month subscription to Kids+ e-books and audiobooks.Request an Amazon Kindle Kids E-Reader for child(ren), age 13-17, and a 12-month subscription to Amazon Kindle Unlimited e-books, magazines, and audiobooks.
Please write each child’s full name and age in field below (click "add row" if enrolling more than one child). If not enrolling for child(ren), please write “N/A”.*
For Adults

If enrolling for adult in household, please complete the section below.
I would like to:

Request a subscription to Audible for access to thousands of audiobooks, originals, and podcasts.Request a subscription to Amazon Kindle Unlimited for access to millions of e-books, magazines, and audiobooks from any device with the Kindle app.
Please write adult's full name in field below. If not interested in a subscription, please write “N/A”.*
ACKNOWLEDGEMENT: By signing below, I attest that the information provided on this Form is correct as of this date and confirm that I am a Vernon resident eligible to participate in the Vernon Reads! Virtual Library Program.
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Vernon Reads! Virtual Library Program Enrollment Form

For Kids

For Adults