Program Application Form First Name* Last Name* Email* Phone Number Example: 0xxxxxxxxx Mobile* Example: 04xxxxxxxx Title* eg. Principal, Teacher, Librarian I am expressing interest on behalf of my* --None-- School Organisation Early Learning (0-5) Community Group School/Organisation Name* Street* Suburb* State* --None-- ACT NSW NT QLD SA TAS VIC WA Post Code* Country --None-- Australia Website* How many students/children do you support?* Please select the program you are most interested in --None-- Library Regeneration Book Bank Read At Home I am interested in all programs Undecided Please explain why your school/community centre requires support for new books* Approximately how many books do you have in your library?* Have you received any financial support for books in the past 12 months?* e.g. grants or donations What is your annual budget for new books? * Do you have a library?* --None-- Yes No Do you run any library programs? Please explain* How many librarians/ teacher librarians does your school or community group have?* How would you describe the average condition of your current books? * --None-- Excellent Condition Good Condition Average Condition Poor Condition How did you hear about Dymocks Children’s Charities?* Additional Questions/Comments * I have read and understood the Terms of Agreement. Sign up to our newsletter. We respect your privacy – click here to view our privacy policy.
