BILLERICA PUBLIC SCHOOLS 2008 SUMMER READING PROGRAM

PARENTAL VERIFICATION

Child's Name: _______________________________________________

School: ____________________________________________________

Teacher's Name in September 2008: ______________________________

Grade and Room Number in September 2008: ______________________________________


Title: ________________________________________________

Author: ______________________________________________

Date: ________________________________________________

Parent's Signature: ______________________________________


Title: ________________________________________________

Author: ______________________________________________

Date: ________________________________________________

Parent's Signature: ______________________________________


Title: ________________________________________________

Author: _______________________________________________

Date: _________________________________________________

Parent's Signature: _______________________________________


Title: _________________________________________________

Author: ________________________________________________

Date: __________________________________________________

Parent's Signature: ________________________________________


Title: ___________________________________________________

Author: __________________________________________________

Date: ____________________________________________________

Parent's Signature: __________________________________________