PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on Governance of the Rochester city school district are requested to complete this reply form as soon as possible and email, mail, or fax it to:

Michelle Newman
Principal Committee Assistant
Assembly Committee on Education
Alfred E. Smith Bldg., Suite 1147
80 So. Swan Street
Albany, New York 12248
Email: newmanm@assembly.state.ny.us
Phone: (518) 455-4881
Fax: (518) 455-4128
box
I plan to attend the public hearing on Governance of the Rochester city school district to be conducted by the Assembly Committee on Education on June 18, 2010.
box
I will address my remarks to the following subjects:

___________________________________________________________________________________

___________________________________________________________________________________

box
I plan to provide written testimony only and will submit it prior to 5:00 pm the day before the hearing.
box
I do not plan to attend the above hearing.
box
I would like to be added to the Committee's mailing list for notices and reports.
box
I would like to be removed from the Committee's 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:
___________________________________________________________________