Central Valley Book Bank - Registration Form

Helping the Valley to Read

a project of
United Way of Fresno County logo

Bank Account Registration

Account Registration Form
	* - Required Field
Name of Organization*:	A value is required.
Address*:	A value is required.
City*:	A value is required.
State*:	A value is required.
Zip*:	A value is required.
Phone Number*:
Website URL (If applicable):
Organization is a (Select one)*:	Non profit 501(c)(3) Federal ID# Title 1 School Charter School Other (please specify)
Primary contact person for information about book needs and distribution
Name*:	A value is required.
Title*:	A value is required.
e-mail*:	A value is required.
Phone*:
If you are a school please provide a description of the characteristics or demographics of the children who will be receiving books. If you are not a school, please provide a statement of your mission and how improved access to books for your target population will help your organization fulfill this mission.
(limited to 1000 characters)	A value is required.