Book Request Form Please Note: For book orders of more than 1000 books, please contact our Operations Manager, Dana Powell, at [email protected]. These orders require more planning and are subject to current book inventory availability. *Indicates a field is required First Name* Last Name* Email* Organization/School Name* Title Phone* Preferred Phone: –None–HomeWorkMobileOther Address Information Street* City* State/Province* Zip Code* Country* Books Information Please provide the number of books for each category Board Books (Birth – Pre-K): Picture Books (Pre-K – 2nd Grade): Early Chapter/Advanced Picture (2nd Grade – 4th Grade): Upper Chapter Books (4th Grade – 5th Grade): Middle School Books Requested (6th Grade – 8th Grade): High School Books Requested (9th Grade – 12th Grade): Adult Books (18 and Up): Religious Books: Activity Books: Free Bookmarks for Students: Other Book Distribution Information Anything else we should know about the books you are requesting? How many children do you plan to serve with these books?* (Please enter numbers only, no text or number ranges) What specifically will these books be used for? (Hold down the Ctrl button to select more than one option.)* Building Home LibrariesClassroom LibrariesBook GiveawayLiteracy or Curriculum Night/FairSummer Reading/Summer SlideOther How many books do you plan to provide per child?* (Please enter numbers only, no text or number ranges) What date would you like to pick up your books? Pick-up days are Monday-Thursday. (Please enter a date in the format mm/dd/yyyy)* What time would you prefer to pick up your books on the date you selected? Pick up times are between 9:30am-3:30pm.* When is your expected book distribution date?* Would you like to self-select your books or have them pre-boxed by Promising Pages staff?* –None–Self-SelectPre-Boxed