Impact Library Program Application

Impact Library Program Application

Applicant Contact Information

Please note the Impact Library Program is only open to applicants in the United States.

First Name

Last Name

Phone

Organization Name (if applicable)

Email

Address Line 1

Address Line 2

City

State/Province

Postal Code

Country

The Impact Fund is only available to applicants in the United States.

Is the Library's location the same as the applicant address above?

YesNo

Library's Location

Address Line 1

Address Line 2

City

State

Postal Code

Country

The Impact Fund is only available to applicants in the United States.

Is the shipping address where the Library should be sent the same as the applicant address above?

YesNo

Shipping Address

Address Line 1

The shipping address must be a U.S. address.

Address Line 2

City

State

Postal Code

Would you prefer a pre-built Little Free Library or a Kit?

Pre-built LibraryKit (pieces are pre-cut, hardware and step-by-step instructions included)Either is fine

Describe the demographics of the community being served. Who are the people who will be using the Little Free Library book-sharing box?

200 words maximum

How will you maintain a flow of books for your book-sharing box?

200 words maximum

What kind of impact will your book-sharing box have on the needs of your community?

200 words maximum

I authorize Little Free Library to use the submitted story above at their discretion, in print and electronic materials. I understand that my contact information will never be shared with outside parties without my permission.

YesNo

How did you find out about this opportunity?

I agree to the following obligations if I receive a Little Free Library:

I will install the Little Free Library at the location designated above.
I will maintain the Little Free Library for a minimum period of one year.
I will add the Library's location and photo to the world map.
I will keep the Little Free Library stocked with books.
I will perform one or more Little Free Library neighborhood activities.
I will respond to media requests if contacted.

Yes, I agree to the above conditions.

Yes, I am 18 years or older

Do you wish to be considered for other free or reduced-cost Library opportunities?

YesNo

Comments:

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