NYSBCN New York State Breast Cancer Network Tenth Annual New York State Breast Cancer Advocacy Day Access To Care: Protecting Our Rights TUESDAY, April 8, 2008: 9:00am - 3:00pm Legislative Office Building - HEARING ROOM C REGISTRATION FORM NAME_____________________________________ ADDRESS__________________________________ TELEPHONE #______________________________ E-MAIL___________________________________ ORGANIZATION_____________________________ I will attend with my local breast cancer organization______ I will attend, but I need a local group to attend with _______ I have enclosed my registration fee: $20 registration fee __________ $10 student fee _________ Please make check payable to: Capital Region Action Against Breast Cancer (CRAAB!) If you are NOT a member of a New York State breast cancer community-based organization, please contact our CRAAB affiliate directly at (518) 435-1055 with the names of your state representatives (Senate and Assembly) or your address. You will be directed to a breast cancer organization in your region and that group will make an appointment for you. Please fax your registration form to (518) 435-1245 or mail to: Capital Region Action Against Breast Cancer (CRAAB!) 125 Wolf Road: Suite 124 Albany, NY 12205 Deadline is No later than April 1, 2008 NYSBCN 1042 Comfort Road, Spencer, NY 14883 phone: (607) 279-1043 fax: (917) 591-8108 email: nysbcn@earthlink.net website: www.nysbcsen.org