PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing regarding the recent movement to reform the current service delivery system for people who are blind or visually impaired in New York State are requested to complete this reply form as soon as possible and send it to:

Judi West
Legislative Analyst
Assembly Committee on Children & Families
Room 522, Capitol
Albany, New York 12248
E-mail: westj@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693


box I plan to attend the following public hearing regarding the recent movement to reform the current service delivery system for people who are blind or visually impaired in New York State to be conducted by the Assembly Task Force on People with Disabilities, the Committee on Health, the Committee on Children and Families and the Committee Education on September 25, 2007.

box I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

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I will address my remarks to the following subjects:





box I do not plan to attend the above hearing.

box I would like to be added to the Task Force and Committees mailing lists for notices and reports.

box I would like to be removed from the Task Force and Committees mailing lists.

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I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:






NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

TELEPHONE:

FAX TELEPHONE:

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