READ TO ME - Registration Form

Use the registration form below to sign up for upcoming READ TO ME activities. If you have any questions please contact Susan directly via email at Susan@readtomeprogram.org. For details including dates and times for these planned activities see our events and activities page.

Sorry, there are currently no scheduled registration events. If you wish to send us your contact information in order to be notified of up coming events, please complete the form below. Thank you.

I am registering for the following*:
(Select event)

Name*:

Address:

City*:

State*: Zip:

Preferred tel:

Email*:

I want to:

Start program
Please indicate possible venues:

School day care center
Social services agency
Library
Other

What affiliation, if any, do you have with an agency where RTM can be implemented?

Volunteer
Please indicate all that apply, as well as experience and knowledge in those areas.

Work in classroom with children
Prep activities
Arts & Crafts
Book selection
Author-illustrator bookings
Library visits
Publicity
Fund raising
Office help
Other

I am Available:

days
eves
weekends

Be on E-Mailing list

Occupation:
(present/past)

Languages spoken:

Comments:

Can we share your email address with other potential RTM colleagues in your area?

Yes No

How did you find out about READ TO ME?

* required fields