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Home
How You Can Help
Book Drive Registration Form
Book Drive Registration Form
Please tell us about yourself and your plans:
(
*
denotes required fields)
First Name of Contact Person:
*
Last Name of Contact Person:
*
Street Address:
*
Address Line 2:
City
*
State:
CONNECTICUT
ZIP Code:
*
County:
*
Choose…
Fairfield
Hartford
Litchfield
Middlesex
New Haven
New London
Tolland
Windham
Phone:
*
Email:
*
Book drive is a project of a/an:
*
Individual
Group
Is this your first book drive for Read to Grow?
*
Yes
No
Inspiration for running this book drive:
How did you hear about Read to Grow?
*
Choose…
Media (TV, newspapers, etc.)
Social media / Internet
Health care facility
School
Word of mouth
Other
If other, please specify:
Name
This field is for validation purposes and should be left unchanged.
