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
Brian Kavanagh

237 First Avenue, Suite 407
New York, NY 10003
212-979-9696


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