PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on The Cost of Higher Education in New York State are requested to complete this reply form as soon as possible and mail, email or fax it to:

Lesley Adewunmi
Committee Assistant
Assembly Committee on Higher Education
Alfred E. Smith Building, Suite 1147
Albany, New York 12248
Email: adewunmil@assembly.state.ny.us
Phone: (518) 455-4881
Fax: (518) 455-4128
box
I plan to attend the following public hearing on The Cost of Higher Education in New York State to be conducted by the Assembly Committee on Higher Education on December 12th.
box
I plan to make a public statement at the hearing. I will answer any questions which may arise. I will provide 10 copies of my prepared statement.
box
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's mailing list for notices and reports.
box
I would like to be removed from the Committee's mailing list.
box
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: