Budget Advocacy Day RSVP

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Please complete this registration form for the Consumer Directed Action of New York (CDANY) and NY Association on Independent Living (NYAIL) Budget Advocacy Day happening on Monday, February 12.

First name? *

Last name? *

E-mail address? *

ILC or Organization Name *

Street Address? *

City? *

State? *

ZIP Code? *

Phone number? *

Are you a member of Consumer Directed Action of NY (CDANY) or the NY Association on Independent Living (NYAIL)? *

I am a member of CDANY

I am a member of NYAIL

I am a member of both NYAIL and CDANY

Unsure

Neither CDANY or NYAIL

If you are registering on behalf of a group roughly how many people are you planning on bringing?

Please let us know of any reasonable accommodations which would help you or the group you are bringing participate in Budget Advocacy Day. *

American Sign Language (ASL) Interpreting.

Braille

Large print

Interpreter

None

Other:

Do you need accessible parking? Because accessible parking is limited at the Empire State Plaza please reach out to Nicole Mastroianni (nmastroianni@ilny.org) by Monday, January 29.

Yes

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CDANY will have t-shirts available at their registration table. If you would like a shirt please indicate your size and they will do their best to accommodate.

If you are registering for a group, please contact Laura Cardwell (laura@cdpaanys.org) regarding shirts.

Small

Medium

Large

Extra-Large

XX-Large

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Submit

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