News In Education Online Affidavit

Teacher Name *
Prefix
First *
Last *
Suffix
Title *
Email Address *
Phone Number *

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School Name *
School Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Agreement *
 I agree the information in the affidavit is complete and accurate. These copies/licenses were ordered, received and used for access to The Modesto Bee electronic edition Monday - Sunday as part of the curriculum for the dates below. 
From: Enter the start date from the form you received.
To: Enter the end date from the form you received.
Number of copies/licenses received *
Enter the number from the from you received.
Number of students in classroom(s) *
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