Author: Carol Hopkins

Literacy Buddy Application

Name _______________________________________________________________________________
Street _______________________________________________________________________________
City _______________________________State __________________ Zip Code _________________
Business/Organization ______________________________Phone: ___________________________
E-mail: _____________________________________________________________________________
How did you hear about Literacy Buddies? _____________________________________________
Would you like more than one Literacy Buddy? ______ Yes______ No How many?__________
Would you like to assist with writing/mailings? ______Yes ______No
Do you want an orientation session ?____Yes (By phone____ In person____ ) No____
By completing this application, I agree to receive letters from a child in an early learning facility or elementary classroom served through a program affiliated with Charlotte County Reads! (CCR). In turn, I will send a response letter to this child. The child will indicate a specific book or areas of interest, which either I can provide as a book donation or one will be provided through CCR. This exchange will take place three times over the course of the school or calendar year. Correspondence will include the child’s first name only and be addressed through the CCR Literacy Advisor.
Signed ____________________________________________________ Date:_______________________

Please return completed application to:
Carol Hopkins, Literacy Advisor at chopkins@elcfh.org
Early Learning Coalition of Florida’s Heartland, Inc.
2886 Tamiami Tr., Suite 1 Port Charlotte, FL 33952
Phone# 941.255.1650 x 135 www.elcfh.org
Port Charlotte, FL 33952
941.255.1650