Fax/Email Back RSVP
Health Care Reform in Rhode Island:
Countdown to Coverage
Wednesday, May 30, 2012
8:30
a.m. - 11:30 a.m.
(Registration
and breakfast start at 8:00 a.m.)
at
Crowne Plaza
801
Greenwich Avenue, Warwick, RI
~~~
Please register me:
Name:
__________________________________________________________
Title:
___________________________________________________________
Organization:
____________________________________________________
Address:
________________________________________________________
City: __________________ State: _________________ Zip: ____________
Phone:
__________________________ Fax: ___________________________
Email:
__________________________________________________________
Additional
members of your organization (add more sheets if needed):
_______________________________________________________________
Name/Title/Phone/Email
_______________________________________________________________
Name/Title/Phone/Email
_______________________________________________________________
Name/Title/Phone/Email
Space
is limited.
Please fax
to Jennifer Capaldo, Rhode Island KIDS COUNT
at (401) 351-1758 or email to jcapaldo@rikidscount.org
by Friday, May 25, 2012.
