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Advocate Sign-up Form
Thank you for adding your name to the ever-growing list of advocates ensuring that Consumer Directed Personal Assistance (CDPA) continues to grow & stay strong in New York State.
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Street Address
Example: 123 Main Street
(Required.)
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4.
City
(Required.)
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5.
State
(Required.)
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6.
ZIP Code
(Required.)
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7.
Email Address
(Required.)
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8.
Phone Number
Example: 718-555-1234
(Required.)
9.
What skills or talents do you have or are willing to learn?
I can create and share social media posts
I can write op-eds or letters to the editor
Storytelling: speaking and telling your story (on camera) to elected officials, reporters, etc.
I am willing to conduct local (district) office visits in your community
I am willing to travel to Albany and other locations for actions and office visits
I have personal or professional connections that can help the movement.
I can offer transportation assistance to consumers who do not have transportation.
I am not sure, but I'd like to learn more.
