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Program Book Request Form

This form is for programs and

Tell us about yourself:
(* denotes required fields)
Official School / Organization Name
         Your Title *
Your First Name *
         Your Last Name *
School/Organization Address
State       Zip
Program Phone *
County *
Program Email *

Are you a state agency?
Yes No
Are you a municipal agency?
Yes No
Type of Program? *:
Are you a Title I program?
Yes No
Please describe your program:

How many books are you requesting (please be specific)?
Number of children to be served?

Special requests (board books, picture books, chapter books, non-fiction, series):
If non-fiction, specify subject(s):

How will the books be used? *
If request is for a special event, by when are the books needed?

Age(s) of book recipients:
Reading level (if applicable):

How did you hear about Read to Grow? *:

Payment and Shipping Information

Select Delivery Method *
Pick Up Books at Branford Warehouse (no delivery fee) 53 School Ground Road, Branford, CT 06405. Book pick-ups must be scheduled in advance. Please contact Linda Sylvester or Myra Healy at 203.488.6800. Hours for pick-up: Monday - Friday 9:30am - 4:00pm.
Deliver Books - $10 fee required
- pay by check
- pay by credit card

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