Welcome to United Way of Greater Duluth


Enrollment Status (Please check one):	Re-enrollment - moved to Greater Duluth from other community. New Registration Address Change

Child's Full Name:
Child's Gender:	Male Female
Child's Date of Birth:	,
Parent/Guardian Name:
*Employer:**
Home Address:
City: State:	MN Zip:		4-Digit Postal Code: (if applicable)

Mailing Address* (if different or PO Box):		Note: I certify that this child is a resident of the Greater Duluth area – defined as zip codes starting with 558
*City: State:*	MN *Zip:**		*4-Digit Postal Code:** (if applicable)
Phone:
*Email Address:**

How did you learn about Imagination Library:
If you have any questions, please call Jennifer Peterson at 218-726-4770.

Please notify United Way of Greater Duluth if your address changes. Books are mailed to the address provided. Please allow 8 - 10 weeks for your first book to arrive. All families receive 'The Little Engine that Could' as their first book. Each month following, your child(ren) will receive other new books, selected specifically for your child's age.

Once enrolled, children will stay on the mailing list until they reach the age of five.
Fill out one form per child.

* Fields are Optional