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Newspaper In Education AFFADAVIT

Name of School:	_________________________________________
Name of Teacher:	_________________________________________

Number of newspapers received on delivery days:
_________	Monday	_________	Thursday
_________	Tuesday	_________	Friday
_________	Wednesday	_________	Sunday

I, ________________________ confirm that my classroom requested and received _____________________ copies of The Daily Journal during the 2005 - 2006 school year.
______________________________________
Teacher Signature
______________________
Date

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