PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on mental health services for returning veterans are requested to complete this reply form as soon as possible and mail it to:

Steven McCutcheon
Legislative Assistant
Assembly Committee on Veterans' Affairs
22nd Floor AESOB
Albany, New York 12248
Email: mccutcheons@assembly.state.ny.us
Phone: (518) 455-4355
Fax: (518) 455-7250


box I plan to attend the following public hearing on mental health services to be conducted by the Assembly Committees on Veterans' Affairs and Mental Health on Tuesday, October 9, 2007.

box I plan to make a public statement at the hearing. My statement will be limited to 10 of minutes, and 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 mailing list for notices and reports.

box I would like to be removed from the Committee 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:
Back