Book-Up! Summer Reading Program Book Request Form
Please fill out for each child if more than one is participating in Book Up!
Student Name
*
First Name
Last Name
Parent Name
*
First Name
Last Name
Parent/Guardian E-mail
*
example@example.com
Please list any book titles/genres you would like to receive, and we will do our best to find those/similar books in our book closet:
Will you be able to pick up the books from the STAIR office? (1535 State St)
*
Yes
No
Please fill out address below if you cannot pick up coupons from STAIR Office!
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Each time you fill out this form, we will give you 5 free books from our STAIR library for your reader to keep! You are able to submit this form up to 3 times (for 15 books) after each bag of books is read. After each book, please submit it through the Book Submission Form, and after 5 books, you will receive a free coupon for Reginelli's.
Submit
Should be Empty: