| First Name |
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| Email |
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| Phone Number |
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| Age and Reading Level |
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| Are you an adult looking for read-aloud suggestions for a young child? |
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| If yes, please tell us the age of the child and a few of their favorite subject areas; i.e., dogs, trains, princesses, dinosaurs, etc. |
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| Gender |
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| Name some of your favorite authors. |
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| List some of your favorite books. |
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| List some books you disliked and what you disliked about them. |
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| What are your favorite fiction genres? |
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| Other? |
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| What kind of non-fiction do you enjoy? |
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| Other? |
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| Would you like your list to include fiction, non-fiction, or a mix of both? |
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| Would you like any audio books? |
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| Do you have any hobbies or interests that you'd like to read about in the plot of a fiction novel? |
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| Are there any subject areas, world views, political views, etc. that you would rather not read about? |
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| You may use this space to tell us anything else about yourself, or your reading choices that have not been addressed by the questions above. |
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| Thank you! |
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