Scholarship 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 this form to recieve a scholarship to attend this event and select a "Scholarship Ticket."

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Contact Information

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Employer Information

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Ticket & Guest Information

Please select "Quantity: 1" for a "Scholarship Ticket." If you have any issues, please email organize@rightcarealliance.org.

Ticket Level		Quantity
Scholarship Ticket ($0)		`Number of Scholarship Ticket tickets ($0 each)`
Ticket Contribution (optional) (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)