Teacher Verification Form

Each school year our newspaper auditors require the Newspapers In Education (NIE) program to have on file an affidavit from every teacher to whom we have provided newspapers and curriculum materials. Please take a few minutes to review and confirm the accuracy of the information provided. Thank you for your assistance in this very important process.

I ordered and received copies of the
Dayton Daily News
Springfield News-Sun
Journal News
Middletown Journal

Start date Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2007 2008 2009

End date Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2008


The quantity is listed below.
Monday
Tuesday
Wednesday
Thursday
Friday

I also received the following supplements on the dates indicated:
Constitution Day 9/11/07
Guide to Higher Education (high schools only) 9/27/07
What2Be (Middle and high schools only) 9/19/07 and 2/13/08

By filling out and submitting the information below, I confirm that I received this order for newspapers and curriculum materials that were used in our classrooms during the 2007-2008 school year.

Teacher Name:

Email:

School Name:

School Address:

City

State

Zip Code

Phone