PUBLIC HEARING REPLY FORM

Persons interested in presenting testimony at the public hearing on Aging Services Modernization in New York City to be held on April 18, 2008, or who wish to submit written testimony only, are requested to complete and return this reply form to:

Erin Cunningham
Assembly Committee on Aging
Alfred E. Smith Office Building
80 South Swan St., Floor 22
Albany, New York 12248
Phone: (518) 455-4355
Fax: (518) 455-7250


box I plan to attend the public hearing on Aging Services Modernization in New York City to be conducted by the Assembly Committees on Aging, Cities, and Consumer Affairs & Protection, and the Assembly Subcommittee on Outreach and Oversight of Senior Citizen Programs on April 18, 2008.

box I plan to make a public statement at the hearing. My statement will be limited to 5 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 Committee mailing list for notices and reports.

box I would like to be removed from the Committee mailing list.

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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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