There is no charge to have the following announcement printed in the Independent. You can submit it either by mail (to P.O. Box 242, Wood-Ridge, NJ 07075-0242) or placing it in the dropbox in the foyer at 210 Hackensack Street.

When filling out this form, circle the appropriate words as indicated.

_______________________________________________, [son / daughter] of ____________________________________
                                     (name)                                                                                                      (parents)

of __________________________________________________, has been named to the [President's / Dean's / Honors] list at
                                      (town)

____________________________________________________ for the [first / second / third / fourth]  [semester/marking period]
             (name of high school, school or college)

where [he / she] if a [freshman / sophomore / junior / senior] year student.

(Add for college students only): majoring in __________________________________________________________________.

[He / she] is a ______________ graduate of ________________________________________________________ High School.

[NOTE: If you wish, you can have any society memberships, academic achievements, or sports affiliations of the student
included in this announcement. We will print such information if space permits, but only once per each school year.]

Society membership(s): ____________________________________________________________________________________

________________________________________________________________________________________________________

Academic achievements: ___________________________________________________________________________________

________________________________________________________________________________________________________

Sports affiliations: _________________________________________________________________________________________

________________________________________________________________________________________________________