Chemung ARC: Advocacy, Resources, and Care

... our quarterly membership newsletter.

In our effort to serve you better and provide informative and interesting features in the quarterly publication of the membership newsletter, Futures, we'd like to get your feedback. Let us know if the current publication meets your needs or if there are some topics of interest or suggestions to include in upcoming issues. Many of you have expressed a desire to receive the newsletter electronically (after all, going green is the future) and this is a service the agency does offer.

We thank you in advance for your input and appreciate your membership with Chemung ARC.

Email address (REQUIRED)
First Name
Middle Initial
Last Name
Address
Address continued
City
State	INT for Non-US
ZIP or Postal Code
Country
Daytime phone
Evening phone

Which delivery method is your preference?

	Mailed Copy
	Electronic Copy (via email) -- this is a new service.

Which sections do you read that are of interest to you?

	President's Message
	Executive Director's Message
	CLASS ACT Self-Advocacy Report
	Program Features
	Awards & Accolades
	Chemung ARC Focus
	Photo Gallery
	All of the Above

Are there any features or topics of interest that you would like added? Such as diagnostic information (i.e. autism) or other health issues, legislative issues on the forefront, updates from the State office, etc. Please list topics and include how often the topics should be published (i.e. make this a regular quarterly feature, or once a year, twice a year, etc.)

Additional comments

Include your name and phone number here if you would like more information about volunteer opportunities?

Name:
Phone Number:

Print & mail to:
Newsletter Survey
Chemung ARC
711 Sullivan Street
Elmira, NY 14901

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