Registration Form for Right Care Alliance Teach In

Health Care Activism Teach In

Monday, January 15, 2018, 8:00 AM to 3:00 PM

University Hall, 1815 Massachusetts Ave, Cambridge, MA 02140

This Right Care Alliance event will provide the specialized knowledge, framing strategies, and organizing tactics you need to be an effective advocate for health care reform. Speakers at this event will cover the following topics: drug prices, single payer system, overuse, neighborhood health stations, primary care as a foundation, how pharma works, and inequities and social determinants of health. Please complete the following form to register for this event.

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Contact Information

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Street Address

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Employer Information

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Ticket & Guest Information

We do not want cost to be a barrier to attend. If you have any concerns, please email organize@rightcarealliance.org.

**Important Note** address listed above must match billing address for payment information below.

Ticket Level		Quantity
General ($50)		`Number of General tickets ($50 each)`
Scholarship ($0)		`Number of Scholarship tickets ($0 each)`
Additional Contribution (Optional)
TOTAL: $0		QTY: 0

Additional Information

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We want to create a comfortable and inclusive environment for all participants. Please list any accommodations you may need (ex: ADA accessible room, lactation room) (Optional)

Please list any dietary restrictions or allergies you have. (Optional)