New York State Breast Cancer Network to Hold 14th Annual Susan M Cohen Education and Advocacy Day – The Future of Health Insurance in New York State

Where:
Empire State Plaza Convention Center, Albany, NY

When:
March 20, 2012

Special Presentation NYS Health Insurance Exchange, Speaker Carrie Tracy Health Policy Associate with Community Service Society of New York and Campaign Coordinator for Health Care for All New Yorkers (HCFANY)

Registration Form

New York State Breast Cancer Network

14th Annual

Susan M. Cohen Education and Advocacy Day

“The Future of Health Insurance in New York State”

TUESDAY, March 20, 2012: 10:00am – 3:30pm

Empire State Convention Center, Room 1

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:

$25 registration fee __________ $12 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 March 13, 2012