Name
_________________________________________________________
Teacher ________________________________

4th & 5th Grade
NEWBERY MEDAL READING CLUB
Each time you read 5 Newbery
Medal books (gold or silver), return this log to the media
center.
Your name will be added to our Newbery Club
display for each 5 books you read !
1. Title___________________________________________________________________
Author ________________________________________________________________
2. Title___________________________________________________________________
Author ________________________________________________________________
3. Title___________________________________________________________________
Author ________________________________________________________________
4. Title___________________________________________________________________
Author ________________________________________________________________
5. Title___________________________________________________________________
Author ________________________________________________________________

Parent
/ Guardian Signature
______________________________________________________________
(required)
Return this form
to the Wilson Creek Media Center