Kindergarten Readiness In Your Community Materials Request Form

Outreach Workshops Materials Request Form
Library Info
Library Name*
Contact Name*

First NameLast Name
Contact Job Title*
Contact Phone*

Area CodePhone Number
Contact Email*
example@example.com
Supervisor/Director Email*
example@example.com
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Materials Request:
REMINDER: Outreach Workshops are limited to no more than 12 families per workshop.
- You can request up to 12 school supply kits per workshop (one per family)
- We will send you supplies to support each workshop:
  - Positive Playtime: 1 roll of painter's tape & a set of 12 box cutters
  - Reading Together: 1 roll of painter's tape
  - Growing with Music: 1 roll of painter's tape, 24 plastic eggs, 48 plastic spoons
  - Telling Family Stories: 1 roll of painter's tape, 1 pack of 12" x 18" white construction paper
  - Family Card Making: 1 roll of painter's tape, pack of 100 blank cards & envelopes
In exchange for receiving materials from ICfL to support your outreach program, you are required to fill out a summary report following each workshop and to ask adult attendees to fill out a parent survey that you will also send to ICfL.

You can request materials for up to five workshops any time from August - June.
Workshop 1
Date of Workshop 1*

MonthDayYear
Date
Workshop Theme*
Estimated Number of Families (no more than 12)*
Workshop 2
Date of Workshop 2

MonthDayYear
Date
Workshop Theme
Estimated Number of Families (no more than 12)
Workshop 3
Date of Workshop 3

MonthDayYear
Date
Workshop Theme
Estimated Number of Families (no more than 12)
Workshop 4
Date of Workshop 4

MonthDayYear
Date
Workshop Theme
Estimated Number of Families (no more than 12)
Workshop 5
Date of Workshop 5

MonthDayYear
Date
Workshop Theme
Estimated Number of Families (no more than 12)
Thank you for your request!

We will prepare and ship materials for your workshop in the next few weeks. If you have any questions about this program, please contact Jennifer Redford at the Idaho Commisssion for Libraries, (208) 639-4147 or (800) 458-3271 or at jennifer.redford@libraries.idaho.gov.
Should be Empty:

Outreach Workshops Materials Request Form

Library Info

Materials Request:

Workshop 1

Workshop 2

Workshop 3

Workshop 4

Workshop 5

Thank you for your request!