Teen's First Name
Last Name
Library Card #
How would you like to receive your box? (check one) Pick up at the library (Will be available earlier.)Delivered
Address
Town
State
Zip Code
Your email
Phone number
What school do you attend? (check one) Bethlehem HSBethlehem MSSt. ThomasHomeschoolOther: (fill in box)
What grade are you in?
Is this your first box? YesNo
Will you be sharing this box with any other teens in the house? If so, Please provide First Name, School, and Grade for each teen.
What genres are you interested in reading? (check boxes below) Realistic FictionFantasyMystery/Thriller/SuspenseScience FictionAction/AdventureHorrorHistorical FictionRomanceLGBTQ+Nonfiction/Biography/MemoirGraphic Novels
If you would like to give us more information, you can here.
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