PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on New York State Food Policy are requested to complete this reply form as soon as possible and mail it to:

Robert Stern
Assembly Task Force on Food, Farm and Nutrition Policy
Agency #4, 5th floor
Albany, New York 12248
Phone: (518) 455-5203;
fax: (518) 455-5573;
e-mail: sternr@assembly.state.ny.us


box I plan to attend the public hearing on New York State Food Policy.

box I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

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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 Task Force’s and Committees’ mailing list for notices and reports.

box I would like to be removed from the mailing list.

box

I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required.




PLEASE PRINT!


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