Request Copies of Rosa Parks YA Book
Complete the form below to receive five copies of the young readers' edition of "The Rebellious Life of Mrs. Rosa Parks."  Learn about the donation offer here: https://www.zinnedproject.org/news/young-readers-edition-rebellious-rosa-parks/ 

As long as you meet the criteria and respond to the questions as asked, you will receive the books. They will be shipped directly from the publisher (Beacon Press) or their distributor, Penguin Random House.
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
Email address *
Personal or school district email. (Note: Personal email address is preferred since school district emails are occasionally blocked.)
School *
Role *
This offer is for public school staff and teacher educators.
Subject *
Grade level *
This book is for middle or high school. (For elementary school, it is useful for school staff to read and discuss how to reshape the curriculum about Parks and the Civil Rights Movement.)
How will you use the books? *
Offer a description (one or two paragraphs) of how you will use these books in your curriculum this year or next.
How will you share feedback on the book? *
To help spread the word about the book, we ask recipients to plan to give it visibility. Share here how you might do that. It could be sharing a photo of students with the book on social media, asking students to write reviews for Goodreads or other book platforms, student created social media promotions for the book, or other ideas you have.
Connections *
Check all that are true about you below
Required
Media Interviews *
If media is interested in talking with teachers who received the books, can we follow up with you? We would not connect you with media without checking with you first. This question is just to determine if it is even a possibility.
Is the mailing address you are providing a school or home address? *
Mailing address line one (school or organization)
Use this line ONLY if there is an school or other organization name in the address.
Mailing address line two *
It must be a street address, no PO boxes. Please use abbreviations (Ave, St, Ln., Ct. etc.)
City *
Please spell out the name of the city, no abbreviations
State *
Use the two-letter abbreviation, in caps.
Zip code *
Questions or comments.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Teaching For Change. Report Abuse
Google Forms