New Worlds Reading

Enrollment Form

Family/Caregiver
and Child Info

1

Book
Interests

2

Shipment
Address

3

Complete the form below for your eligible student to receive a FREE book in the mail each month during the school year! Once you review and submit, you will be given the option to enroll additional eligible students.

Book delivery will begin 6-8 weeks after completing this enrollment form. Please double-check to make sure all information is correctly entered so that shipping is not delayed.

All information is required unless otherwise indicated.

Family/Caregiver Name and Contact Information

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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

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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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Shipment / Mailing Address

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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.

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Validate Your Address

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Confirm Your Address

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Address
City, State
Zip
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City,State
Zip
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