[INSERT LETTERHEAD HERE] Scholastic Inc. 557 Broadway New York, NY Attn: Karen Fuchs Ph: 212-343-4447 Date (DATE OF ISSUE): MONTH/DAY/YEAR RE: Chemicals of High Concern to Children (CHCC) Declaration Title: ISBN: P.O.#: Product Manufacture date: month/year Vendor: Mark one: Contains reportable chemicals of high concern for children. If yes, provide the following: Component Reportable Concentration State requiring Reported by Date Chemical reporting vendor Reported (Y/N) Does not contain reportable chemicals of high concern for children Sign and date below and submit to . Name of Issuer & Title Signature Date
[INSERT LETTERHEAD HERE] Scholastic Inc. 557 Broadway New York, NY Attn: Karen Fuchs Ph: 212-343-4447 Date (DATE OF ISSUE): MONTH/DAY/YEAR RE: Chemicals of High Concern to Children (CHCC) Declaration Title: ISBN: P.O.#: Product Manufacture date: month/year Vendor: Mark one: Contains reportable chemicals of high concern for children. If yes, provide the following: Component Reportable Chemical Concentration State requiring reporting Reported by vendor (Y/N) Date Reported Does not contain reportable chemicals of high concern for children Sign and date below and submit to . Name of Issuer & Title Signature Date
CHCC-Declaration-Letter.docx