Home >>

Mental Health MaTTeRs
Legislative Day

Sponsored by the Mental Health Association in New York State (MHANYS) and the New York State Chapters of the American Foundation for Suicide Prevention (AFSP)

March 10, 2010, 8:30 to 4:30
Meeting Room 6 Empire State Concourse, Albany NY

Space is limited. If you plan on attending please complete the information form below

Fields marked with an * are required

First Name:	*  MI
Last Name:	*
Title:
Organization:
Address:	*
City:	*
State:	*
Zip Code:	*
County:
Phone:	*
Alt. Phone:
Fax:
Email:	*
Are you are planning to schedule meetings with your representatives: Yes No
If yes, I will make an appointment with Senator and Assemblymember .
I would like to donate $ towards the costs of this event.
I am unable attend this event but would like to donate $ towards the costs of this event.