This application is due by May 10th. We will notify you at the end of May.

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* 1. Your Name:

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* 2. Email (This is also the email that Lakeshore Learning will use.)

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* 3. Clinic Name:

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* 4. In order to be considered for this opportunity, we are asking clinics to share two of the following with us to help us continue to build support for RORCO at your clinic and all the clinics on our waitlist. If you need time to gather a quote or photo, please let us know your intention to do so below. If you are ready now, just put it in the text box below. You can email your photo to emily@reachoutandreadco.org.

1) Share a parent testimonial that makes the connection between receiving books and literacy guidance at your clinic and how it impacts their reading routines at home.
and/or
2) Provide RORCO with a photo of a parent/child/provider reading together in your clinic. You can find our photo release here.
and/or
3) Ask a provider to share a quote about how the ROR model positively impacts well child visit attendance, overall health outcomes, and the provider/caregiver relationship.

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* 5. As a recipient of funding, you agree to:

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