Science Fiction Youth Program
Nomination Form for Recipients

Nominate a worthy recipient here so we can match the organization with a donor. Get your local library, school, or other youth organization free SF books and magazine subscriptions!

If this form doesn't work for you, or if you use an older web browser, send an e-mail to Chris McKitterick for more information:

A printable text version of this enrollment form is also available; this form requires that you have configured an email program on the computer you are using.

Privacy information: Note that the Center coordinator for this project (Chris McKitterick) is the only person who will see your personal information. We will not share this personal information with any third party, except to fulfill a magazine subscription or book request.

 I want to register an organization to receive a subscription to an SF magazine

 I want to register an organization to receive SF book(s)

 I would like more information

 I would like to be added to a blind-cc mailing list-serve to discuss related topics

Your name:

Organization name:

Book or magazine preference (list as many as you wish):

Street address (where to send the books/magazines):

City:

State and Zip:

Phone number:

Organization's (or, if none, your) email address:

  

When you click "Submit," you might see a dialog box asking if you really want your browser to send an email on your behalf, and it might ask if this is expected behavior or a possible virus. This is normal behavior for submitting a web form, so click "OK," "Send," or the equivalent.

If you have trouble using the form, e-mail Chris McKitterick for more information. A printable text version of this form is also available.


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