New York State Assembly
Excellence in Reading
Certificate

Information Form


Name of Child


School

Grade


Parent’s Name


Street Address


City or Town

Zip

Number of days completed

Favorite Books





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

Assemblywoman
Sandy Galef
2 Church Street
Ossining, New York 10562
(914) 941-1111



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