Imagination Library in Bethel

Thank you for signing up for a program that has so many great benefits!

In order to be eligible for United Way of Western Connecticut’s Imagination Library, the child you’re registering must be:

Under 5 years of age and a resident of Bethel

If the above is true, please proceed and submit this online form to start building your United Way Imagination Library!

Child's Last Name (Required)

Child's First Name (Required)

Child's Gender (Required)

Male
Female

Child’s Birthday

Month (Required)

Day (Required)

Year (Required)

Parent/Guardian's Name (Required)

Child’s Home Address (Required)

Apt / Floor / Unit No.

City/State: Bethel, CT

Zip Code (Required)

Phone Number (Required)

E-Mail Address (Required)