Enrollment Form

Family/Caregiver
and Child Info

1

Book
Interests

2

Shipment
Address

3

Please enter your child's information, including the school and grade for the upcoming 2022-2023 school year, in the enrollment form below. All information is required unless otherwise indicated.

Once you review and submit, you will be given the option to enroll additional eligible students.

Family/Caregiver Name and Contact Information

This field is required.

Name must be between 2 and 30 characters.

Field cannot contain special characters.

This field is required.

Name must be between 2 and 30 characters.

Field cannot contain special characters.

A phone number or email address is required.

Please enter a valid email address.

Please enter a phone number in a valid format.

Student Information

This field is required.

Name must be between 2 and 30 characters.

Field cannot contain special characters.

This field is required.

Name must be between 2 and 30 characters.

Field cannot contain special characters.

This field is required.

This field is required.

This field is required.

This field is required.

Next

Select your child's top THREE favorite types of books:

Please select 3 book categories.

Select your preference for specialized book titles. When available, you will receive books based on your preference:

Select at least one specialized book title.

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Next
Program only shipping to Florida state addresses.

Shipment / Mailing Address

This field is required.

This field is required.

This field is required.

This field is required.

Please check the box to agree to the enrollment terms and conditions.

That combination of city, state, and zipcode do not match any known addresses. Please edit and try again.

Check Address and Submit
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Validate Your Address

Choose the address suggested below to ensure an accurate delivery.

Use this address
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Confirm Your Address

We couldn't verify the exact address you entered. Please double check to confirm it's correct or make any necessary changes.

Address
City, State
Zip
Edit Address
save and continue
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Validate Your Address

We couldn’t verify the address you entered. Did you mean this address?

Address
City,State
Zip
Use This Address
Edit Address

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