Presents
What Is It?Dolly Parton’s Imagination Library is a 60 volume set
of books beginning with the children’s classic The Little Engine
That Could™. Each month a new, carefully selected book will be
mailed in your child’s name directly to your home. Best of all it
is a FREE GIFT! There is no cost or obligation to your family.
Who Is Eligible?Preschool children ages birth to five who are
residents of St. Joseph County.
What Are My Responsibilities?1. Be a resident of St. Joseph
County.
2. Submit an official registration form, completely filled out
by parent or guardian. (Form must be approved and on file with
Community Foundation of St. Joseph County.)
3. Notify Community Foundation of St. Joseph County any time
your address changes. Books are mailed to the address listed on the
official registration form. If the child’s address changes, you
must contact the folks at the address on this card in order to
continue receiving books.
4. Read with your child. When Will I Receive Books?Eight to ten
weeks after your registration form has been received, books will
begin arriving at your home and will continue until your child
turns five or you move out of St. Joseph County.
Presents
What Is It?Dolly Parton’s Imagination Library is a 60 volume set
of books beginning with the children’s classic The Little Engine
That Could™. Each month a new, carefully selected book will be
mailed in your child’s name directly to your home. Best of all it
is a FREE GIFT! There is no cost or obligation to your family.
Who Is Eligible?Preschool children ages birth to five who are
residents of St. Joseph County.
What Are My Responsibilities?1. Be a resident of St. Joseph
County.
2. Submit an official registration form, completely filled out
by parent or guardian. (Form must be approved and on file with
Community Foundation of St. Joseph County.)
3. Notify Community Foundation of St. Joseph County any time
your address changes. Books are mailed to the address listed on the
official registration form. If the child’s address changes, you
must contact the folks at the address on this card in order to
continue receiving books.
4. Read with your child. When Will I Receive Books?Eight to ten
weeks after your registration form has been received, books will
begin arriving at your home and will continue until your child
turns five or you move out of St. Joseph County.
Dolly P
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Dolly P
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Sign up your child today!Simply fill out the above form and mail
to:
Sign up your child today!Simply fill out the above form and mail
to:
Community Foundation of St. Joseph CountyP.O. Box 837South Bend,
IN 46624
Community Foundation of St. Joseph CountyP.O. Box 837South Bend,
IN 46624
Cut Here Cut Here
Privacy Statement: This inform
ation will not be used w
ithout your permission for any purpose other than those related
to the Im
agination Library. PLEASE PRIN
T
1st Prescho
ol C
hild’s FU
LL Nam
e
____________________________________________________________________________________
Ch
ild’s Date o
f Birth
________/___________
/ ___________
Sex: M
F Ph
on
e ____________________________________
2nd Presch
oo
l Ch
ild’s FULL N
ame
___________________________________________________________________________________
Ch
ild’s Date o
f Birth
________/___________
/ ___________
Sex: M
F Ph
on
e ____________________________________
Parent/G
uardian
’s Nam
e
____________________________________________________________________________________________
Ch
ild’s Ho
me A
ddress
_______________________________________________________________________________________________
ad
dr
es
s
_______________________________________________________________________________________________
t
ow
n/c
ity
pos
t co
de
Postal A
ddress
______________________________________________________________________________________________________
ad
dr
es
s(if differen
t)
_______________________________________________________________________________________________
t
ow
n/c
ity
pos
t co
de
Em
ail Address
______________________________________________________________________________________________________
“Th
is child is a residen
t of S
t. Josep
h C
ou
nty.”
______________________________________________________________________
s
ign
at
ur
e of pa
re
nt/
gu
ar
dia
n
FO
R O
FFIC
E U
SE
ON
LY: D
ate Received: _____________________
G
rou
p Co
de: ____________–_______________________
Privacy Statement: This inform
ation will not be used w
ithout your permission for any purpose other than those related
to the Im
agination Library. PLEASE PRIN
T
1st Prescho
ol C
hild’s FU
LL Nam
e
____________________________________________________________________________________
Ch
ild’s Date o
f Birth
________/___________
/ ___________
Sex: M
F Ph
on
e ____________________________________
2nd Presch
oo
l Ch
ild’s FULL N
ame
___________________________________________________________________________________
Ch
ild’s Date o
f Birth
________/___________
/ ___________
Sex: M
F Ph
on
e ____________________________________
Parent/G
uardian
’s Nam
e
____________________________________________________________________________________________
Ch
ild’s Ho
me A
ddress
_______________________________________________________________________________________________
ad
dr
es
s
_______________________________________________________________________________________________
t
ow
n/c
ity
pos
t co
de
Postal A
ddress
______________________________________________________________________________________________________
ad
dr
es
s(if differen
t)
_______________________________________________________________________________________________
t
ow
n/c
ity
pos
t co
de
Em
ail Address
______________________________________________________________________________________________________
“Th
is child is a residen
t of S
t. Josep
h C
ou
nty.”
______________________________________________________________________
s
ign
at
ur
e of pa
re
nt/
gu
ar
dia
n
FO
R O
FFIC
E U
SE
ON
LY: D
ate Received: _____________________
G
rou
p Co
de: ____________–_______________________
