United Way for Southeastern Michigan’s
Success by 6
What Is It?
Dolly Parton’s Imagination Library is a
60- volume set of books beginning with
the children’s classic The Little Engine
That Could. Each month a new,
carefully selected book will be mailed
in your child’s name directly to your
home. Best of all it is a FREE GIFT!
There is no cost or obligation to your
Who Is Eligible?
Children birth to five that live in
Pontiac, MI with zip codes 48340,
48341, 48342, 48343.
What Are My Responsibilities?
1. Reside in Pontiac, MI
2. Submit an official registration form,
completely filled out by parent or
guardian (form must be approved
and on file with Oakland County
Child Care Council (4C)
3. Notify 4C any time your address
changes. Books are mailed to the
address listed on the official
registration form. If the child’s
address changes, you must
contact the person at the
address on this form in order to
continue receiving books.
4. Read with your child.
When Will I Receive Books?
Eight to ten weeks after your
registration form has been received
and entered in the database, books
will begin arriving at your home and
will continue until your child turns five
or moves out of Pontiac.
Dolly Parton’s Imagination Library Official Registration Form (one form per child
Success by 6 Community
Simply fill out this form
Oakland County Child
550 Hulet Suite 101
database, books will begin arriving at your
Bloomfield Hills, MI
Care Council (4C)
and mail or fax to:
Preschool Child’s FULL Name ______________________________________________________________________________________________
Child’s Date of Birth __________/__________/__________ Sex: M F Phone _________________________________
Parent/Guardian’s Name _________________________________________________________________________________________________________
Child’s Home Address ________________________________________________________________________________________________________
CITY STATE ZIP CODE
Mailing Address (if different) _______________________________________________________________________________________________________
CITY STATE ZIP CODE
“This child resides in Pontiac, MI.”
SIGNATURE OF PARENT OR GUARDIAN