Jacksonville Public Library
Online Registration for the Summer Reading Program

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Your Information


Library Card Number:

Please enter the library card for the child/teen 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 for is for children and teens only. Adults who wish to sign up for the Adult Summer Reading Program, please use the adult registration form.


First Name:


Middle Initial:


Last Name:



Birth Date:(mm/dd/yyyy)


Age:


Parent/Guardian Name:




Contact Information


Phone number:


Email address:



School Information

School information is for statistical purposes only.


School Name:


Other School - not listed above:



Grade Completed at end of current school year:

Grade level information is is used to help determine what books would be on the child's reading level. If your child reads below grade level, please tell a staff member so we will be able to help him/her find books that he/she would enjoy.



Please check if your child will be coming to the library with a Daycare Group this summer.

Name of Daycare:



How did you hear about the Summer Reading Program?


If other, please list how you found out about the Summer Reading Program here:



I agree to abide by the guidelines of the Jacksonville Public Library Summer Reading Program.