New York State Assembly
Excellence in Reading
Certificate


Information Form


Child’s Name


School


Parent or Guardian Name





Address


Phone/E-mail



Number of Days Completed






Favorite Books


To receive your certificate, please have your parents complete the above form and send it with the attached calendar to:

Assemblymember
Linda B. Rosenthal
230 West 72nd Street, Suite 2F
New York, NY 10023
212-873-6368



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