First Library Plus Referral

First Library, a New Jersey nonprofit corporation, is dedicated to early childhood literacy, book ownership and library patronage.

Its First Library Plus program offers first time parents in need books plus clothing and educational toys during their child's first three years of life, free of charge, through its incentive and reward program, while promoting early childhood literacy, journaling, library patronage and healthy and responsible parenting.

Mothers can earn up to 2000 ($1000.00 credit) points a year for books, toys and clothing at our First Library Plus boutique.

Mothers are required to read to their child daily, submit daily reading logs, maintain monthly local library patronage and file quarterly reading surveys and semiannual parent questionnaires.

Mothers must also submit yearly parent pledges for initial and continued participation in the program.

The following requirements must be met for consideration to the program:

*It's the mother's first child.

*The mother is less than 24 weeks pregnant or has a child under one year old.

*The mother is able to commit to the program for five years.

*The mother is currently enrolled in Medicaid, Food Stamps/SNAP, Assistance to Needy Families/Work First NJ, WIC or has extreme financial need.

*The mother is enrolled in a participating service organization program.

To receive the first and subsequent rewards (minimum 200 points) mothers must read to their child (unborn, too) daily, submit a daily reading log, visit their local library monthly, complete one reading survey and answer one parent questionnaire for three months.

The program is voluntarily and participation may be redrawn at any time.

Enrollment and continued participation is limited to first time parents only and may be revoked at any time. Reading survey and parent questionnaire are available upon request. See firstlibrary.org for complete details.

Together, we can build happy, healthy, smart and responsible families.

Catherine Tinger Goldberg

Founder

First Library

First Library Plus

* Required

Email address *

Your email

Primary Language Spoken *

English

Spanish

Other

Child's Birthdate

Your answer

Name of Organization *

Your answer

Ethnicity *

White

African American

Hispanic

Asian

Other

I consent to share the above information with First Library and First Library Plus and request First Library Plus contact the Mother for admission into the First Library Plus program. *

Yes

I agree to provide and/or notify First Library Plus quarterly of the Mother's first time parent status. *

Yes

Resides with *

Spouse / Partner

Family Member

Alone

Unknown

Referred by *

Your answer

Martial Status *

Single

Married

Separated

Widow

Unknown

Business Phone *

Your answer

Father's Last Name

Your answer

Does the Mother have a prenatal care provider? *

Yes

No

Unknown

Father's First Name

Your answer

How likely is the Mother to complete the program? *

50% or more 50% or less

First Year

Second YearThird Year

Second YearThird Year

Completion

First Year

Second YearThird Year

Second YearThird Year

Completion

Mother's Last Name *

Your answer

Date *

Date

mm/dd/yyyy

Is the Mother currently enrolled in Medicaid, Food Stamps/SNAP, Assistance to Needy Families/Work First NJ, WIC or have extreme financial need? *

Yes

No

DOB *

Your answer

Is the Mother attending school? *

Yes

No

Unknown

Is the Mother employed?

Yes

No

Unknown

Child's Gender

Female

Male

Other:

Due Date

Date

mm/dd/yyyy

Child's Name

Your answer

Mother's Email Address *

Your answer

Primary Phone Number *

Your answer

Does the Mother have a pediatric care provider? *

Yes

No

Unknown

Signature (Print acceptable) *

Your answer

Mother's First Name *

Your answer

Home Address (Street, City, State, Zip) *

Your answer

Age *

Your answer