Free Library Initiative Program Application Apply for Free Library Program Step 1 of 2 50% Contact Name* First Last Business Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County Located In*Organization Website Organization Phone*Cell Phone*FinancialsDetermination of 501(c)3 status* Grade levels served* Preschool Kindergarten First Grade Second Grade Third Grade Fourth Grade Number of children in your program*Do you receive any outside funding for a literacy program? If so, please describe*How did you hear about the Free Library Initiative program?*Do you have space available to house a library unit and storytime?* Yes No Pictures of Facility and proposed area for Library Unit and Storytime* Drop files here or Accepted file types: jpg. Are you able to provide transportation of students once per month to our facility?* Yes No Maybe We are applying for the following program* Free Library Initiative Program at our facility Enrollment in Free Library Initiative Program off-site Any of the above
