Reading Council ________________________________________

Author ________________________________Grade ____Spec. Ed./ Title 1 ___ Age ______

Book Title ___________________________________________________________________

I submit this entry into the Tennessee Reading Association Celebrate Literacy Award for consideration of a state award. This entry is to be entirely the work of the student named below, as the only person originating this book and its contents. No help or assistance has been received, with the exception of holistic assistance, in the completion of this entry. All work is original and has not been received from any previous entry. Plagiarism will result in immediate disqualification in this award contest.

I, __________________________________, (student name) do hereby acknowledge that this book is mine alone and that I have not copied or received any assistance in the writing of this book.

___________________________ ________________________________Date:____________

Author’s Signature                              Teacher’s Signature                  

____________________________________Date:____________

Parent’s Signature (if work is done at home)    

Tennessee Reading Association

Celebrate Literacy Award Official Entry Blank

Reading Council ______________________________________________________________

Author ________________________________Grade ____Spec. Ed./ Title 1 ___ Age ______

Book Title ___________________________________________________________________

I submit this entry into the Tennessee Reading Association Celebrate Literacy Award for consideration of a state award. This entry is to be entirely the work of the student named below, as the only person originating this book and its contents. No help or assistance has been received, with the exception of holistic assistance, in the completion of this entry. All work is original and has not been received from any previous entry. Plagiarism will result in immediate disqualification in this award contest.

I, __________________________________, (student name) do hereby acknowledge that this book is mine alone and that I have not copied or received any assistance in the writing of this book.

________________________ _____________________________Date:____________

Author’s Signature                              Teacher’s Signature                  

____________________________________Date:____________

Parent’s Signature (if work is done at home)