Read A Book Worksheets Page 2
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7Personal Information Sheet
Full Name
First
Middle Initial
Last
Home Address
Street Address
City
State
Zip
Email
Day Time Phone Number
Evening Phone Number
Facility Name
Facility Address
Street or Post Office Box
City
State
Zip
Facility Type (Please check one)
Licensed Child Day Center
Licensed Family Day Home
Religious Exempt Child Day Center
Voluntarily Registered Family Day Home
Family Day Home Approved by a
Unregulated Child Care Provider (paid by
Family Day System
local DSS)
Head Start Program
Certified Preschool
Public School Preschool Program
Other (specify)
IMPORTANT REMINDERS:
You MUST submit TWO complete Children’s Literature Book Reports to be eligible to receive training
clock hours.
Each Children’s Literature Book Report MUST have the following worksheets to be considered
complete:
1) Lesson Plan Worksheet,
2) Topic Web Worksheet, and
3) Prop Box or Shadow Box and photograph.
Incomplete materials will be returned to you.
Make yourself a copy of the Children’s Literature Book Report Worksheets BEFORE mailing to Child
Care Aware of Virginia.
Mail completed Read–A–Book Report materials along with $20.00 check or money order, payable to
Child Care Aware of Virginia to:
Child Care Aware of Virginia
Read-A-Book Program
302 Turner Road, Suite D
Richmond, VA 23225
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