Knox's Book Boxes Application
Please fill out the form completely to apply for a book box. The books will be chosen specifically for your child, so the more information we have to go on the better! 

There are no specific financial requirements. If you are having trouble accessing books, we are happy to help. We know that family situations are different and expenses and challenges can come in many forms. 

Please note that the books we send are gently used.
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Child's Name (First and Last)
Does this child have permanent hearing loss?
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Parent Name (First and Last)
Parent Email
Parent Phone Number
Child's Current Age
Child's Primary Communication Mode/Goal (All communication modes are eligible for the program. It is helpful to have an understanding of the goals of families receiving the books.) Choose the mode closest to your desired outcome for your child.
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Child's Hearing Technology (if any)
Please describe your child's language and reading level. Please provide as much information as you can to help us choose appropriate books. 
Please describe book or general topics that interest your child. 
Please provide the title of some books that your child currently enjoys, if you can. If your child is reading a series, please note the books in the series that they have already read, so we can send ones they have not read yet.
Special Considerations: Are there topics that you would like us to avoid? (We have almost 2,000 books on hand and cannot read every book ahead of time, but we will do our best to screen for things important to your family.)
Are there siblings in the home who also need books? If so, please provide each child's name, age, interests and reading level here. 
How many age/reading level appropriate books do you have available to your child at home? 
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Street Address
City
Zip Code
Do you need books in Spanish?
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