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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 zip code 22309.
What Are My Responsibilities?1. Be a resident of zip code 22309.
2. Submit an official registration form, completely filled out by parent or guardian. (Form must be approved and on file with Opportunity Neighborhood.)
3. Notify Opportunity Neighborhood 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 zip code 22309.
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 zip code 22309.
What Are My Responsibilities?1. Be a resident of zip code 22309.
2. Submit an official registration form, completely filled out by parent or guardian. (Form must be approved and on file with Opportunity Neighborhood.)
3. Notify Opportunity Neighborhood 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 zip code 22309.
Dolly P
arton
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Offi
cial Registratio
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Dolly P
arton
’s IMA
GIN
ATIO
N LIB
RA
RY
Offi
cial Registratio
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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:
Privacy Statemen
t: This in
formation
will n
ot be used for any pu
rpose other th
an th
at related to the Im
agination
Library. PLEA
SE
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
_______________________________________________________________________________________________
c
ity
s
tat
e
zip c
od
e
Mailin
g Address _____________________________________________________________________________________________________
a
dd
re
ss
(if different)
_______________________________________________________________________________________________
cit
y
sta
te
z
ip co
de
Em
ail Address ______________________________________________________________________________________________________
“Th
is child is a residen
t of zip
code 2
23
09
” _________________________________________________________________________
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: ____________–_______________________Opportunity Neighborhood-Booksc/o Fairfax Futures12011 Government Center Pkwy.Suite 920Fairfax, VA 22035
Privacy Statemen
t: This in
formation
will n
ot be used for any pu
rpose other th
an th
at related to the Im
agination
Library. PLEA
SE
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
_______________________________________________________________________________________________
c
ity
s
tat
e
zip c
od
e
Mailin
g Address _____________________________________________________________________________________________________
a
dd
re
ss
(if different)
_______________________________________________________________________________________________
cit
y
sta
te
z
ip co
de
Em
ail Address ______________________________________________________________________________________________________
“Th
is child is a residen
t of zip
code 2
23
09
” _________________________________________________________________________
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: ____________–_______________________
Opportunity Neighborhood-Booksc/o Fairfax Futures12011 Government Center Pkwy.Suite 920Fairfax, VA 22035
