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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