2024 NLDSS Membership

Newfoundland & Labrador Down Syndrome Society: 2024 Membership Application

To renew your membership or to become a new member with the Newfoundland and Labrador Down Syndrome Society please complete the form below. If you have any further questions or concerns you can contact our office at 738-3336 or send an email to office@nldss.com
Type of Membership*

Family MembershipFriend of NLDSS

Family Membership

Please complete the following section if you selected 'Family Membership' membership type.
Name of Individual with Down syndrome

First NameLast Name
Date of Birth (Individual with Down syndrome)

MonthDayYear
Date
Name (Parent/Guardian)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number

Area CodePhone Number
Name (Parent/Guardian)

First NameLast Name
Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Phone Number

Area CodePhone Number
Additional Family Members
Daycare/School/Work of the Individual with Down syndrome
Will be used to identify daycares/schools/organizations that may wish to have educational materials available, presentations for staff/students regarding Down Syndrome and to participate in World Down Syndrome Day.
Do you want to receive communication/ updates from NLDSS?

YesNo
Photo Release

Please complete the following section if you would like to provide permission for you and/or your child to be photographed by NLDSS.
I, First Name Last Name give permission to the Newfoundland and Labrador Down Syndrome Society to take pictures of myself and/or my dependent child for promotional use of the organization.
Signature
Date

MonthDayYear
Date

Friend of NLDSS

Please complete the following section if you selected 'Friend of NLDSS' membership type.
Name

First NameLast Name
How do you identify?

Friend of a person with Down syndromeFamily of a person with Down syndromeEducator of a student with Down syndromeHealth Care ProfessionalBusiness/OrganizationOther
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Phone Number

Area CodePhone Number
Name of Individual with Down syndrome (if applicable)

First NameLast Name
Do you want to receive communication/updates from NLDSS?

YesNo
Should be Empty:

Newfoundland & Labrador Down Syndrome Society: 2024 Membership Application