OF NOBLES COUNTY
OF NOBLES COUNTY
Presents
Presents
What Is It?
What Is It?
Who Is Eligible?
Who Is Eligible?
What Are My Responsibilities?
What Are My Responsibilities?
2. Submit an official registration form, completely filled
out by parent or guardian. (Form must be approved
and on file with United Way of Nobles County.)
2. Submit an official registration form, completely filled
out by parent or guardian. (Form must be approved
and on file with United Way of Nobles County.)
3. Notify United Way of Nobles 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.
3. Notify United Way of Nobles 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.
4. Read with your child.
When Will I Receive Books?
When Will I Receive Books?
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.
Preschool children ages birth to five who are residents
of Nobles County.
1. Be a resident of Nobles County.
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 Nobles County.
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.
Preschool children ages birth to five who are residents
of Nobles County.
1. Be a resident of Nobles County.
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 Nobles County.
Privacy Statement: This information will not be used without your permission for any purpose other than those related to the Imagination Library. PLEASE PRINT
Dolly Parton’s IMAGINATION LIBRARY Official Registration Form
Sex: M F
Phone _____________________________________
1st Preschool Child’s FULL Name _____________________________________________________________________________________
Child’s Date of Birth _________ /___________ /____________ Sex: M F
Phone_____________________________________
2nd Preschool Child’s FULL Name ____________________________________________________________________________________
Child’s Date of Birth _________ /___________ /____________ address
post code
post code
Group Code:_____________–_______________________
Phone _____________________________________
Phone_____________________________________
post code
Sign up your child today!
Simply fill out the above form and mail to:
Simply fill out the above form and mail to:
United Way of Nobles County
United Way of Nobles County
OF NOBLES COUNTY
OF NOBLES COUNTY
1121 Third Avenue
Worthington, MN 56187
507-372-7541
Parent/Guardian’s Name_____________________________________________________________________________________________
town/city
Child’s Home Address________________________________________________________________________________________________
town/city
Postal Address_______________________________________________________________________________________________________
address
(if
different)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Email Address_______________________________________________________________________________________________________
Date Received:______________________ “This child is a resident of Nobles County”___________________________________________________________________________
signature of parent/guardian
FOR OFFICE USE ONLY:
Dolly Parton’s IMAGINATION LIBRARY Official Registration Form
Privacy Statement: This information will not be used without your permission for any purpose other than those related to the Imagination Library. PLEASE PRINT
Sex: M F
1st Preschool Child’s FULL Name _____________________________________________________________________________________
Child’s Date of Birth _________ /___________ /____________ Sex: M F
2nd Preschool Child’s FULL Name ____________________________________________________________________________________
Child’s Date of Birth _________ /___________ /____________ address
post code
Group Code:_____________–_______________________
Sign up your child today!
1121 Third Avenue
Worthington, MN 56187
507-372-7541
Parent/Guardian’s Name_____________________________________________________________________________________________
town/city
Child’s Home Address________________________________________________________________________________________________
town/city
Postal Address_______________________________________________________________________________________________________
address
(if
different)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Email Address_______________________________________________________________________________________________________
Date Received:______________________ “This child is a resident of Nobles County”___________________________________________________________________________
signature of parent/guardian
FOR OFFICE USE ONLY:
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