Your Information Library Card Number: Please enter the library card for the ADULT who is going to participate in the program. You cannot use another person's library card to participate in JPL’s Summer Reading Program. This form is for adults only; teens who are still in school will participate in the Teen Summer Reading Program and should fill out the registration form for children and teens. First Name: Middle Initial: Last Name: Age: 16 to 19 20 to 39 40 to 59 60 & up How did you hear about the Summer Reading Program? I have participated in the Summer Reading Program at JPL before. A Library staff member told me about the program. I saw a flyer or sign in the library about the program. I saw a flyer or sign at another location for the library’s Summer Reading Program. I saw the information on the library’s website. I saw a post on the library’s Facebook page. I saw the informaiton in the library’s e–newsletter. I heard about the program at school. I saw an ad in the newspaper. I saw an ad on television. I head about it on the radio. A friend or relative told me about the program. I heard about the progam another way. If other, please list how you found out about the Summer Reading Program here: Contact Information Phone number: Email address: I agree to abide by the guidelines of the Jacksonville Public Library Summer Reading Program.