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:

Assemblywoman
Catherine Nolan

61-08 Linden Street
Ridgewood, NY 11385
718-456-9492


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