Police, Sheriff's, State Patrol and EMS
:  "Need more books?"


Reorder Questionnaire
:  (Copy this form and reply by e-mail to: paul@withwingsandahalo.org)
 

1)  Which type of books are you giving out most often?
 
     ____ Toddler     _____ 5-8 Boys    _____ 5-8 Girls  ____ 9-12 Boys _____ 9-12 Girls   _____ Pre-Teen
 

2)   About how many books are your finding yourself giving out per week?
 
     _____  1- 2   _____ 3-4   _____ 5-6   _____ all of them
 

3)   What book(s) and/or age group are you most comfortable handing Children's Books out to?
 
      List Title(s) _________________________________________________________________
 
      Child's age range _____ Toddler  _____ 5-8  _____ 9-12      or  _____ N/A
 
4)   What book(s) and/or age group are you uncomfortable handing Children's Books out to?

      List Title(s) _____________________________________________________________

      Child's age range _____ Toddler  _____ 5-8  _____  9-12      or  _____  N/A
 
5)   What are some comments or responses you are having from the children and/or parents?

      Please use all the space you need:

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________
 
 
 
Please send us approximately ______________ more books for those children we have highlighted above. 

We think that this amount of books will last us about _____ Weeks  or _____  Months.
 
Send them to us via the following:

Department address:

____________________________________________________________________________________________________________


Contact person:

____________________________________________________________________________________________________________



Ph #__________________________________   E-mail address:_________________________________________________

 

Put them to the attention of the following Chief & City/Village


____________________________________________________________________________________________________________
 

Other Comments:__________________________________________________________________________________________________

____________________________________________________________________________________________________________