BDSRA Fam Funds Interest

Primary Contact*

First NameLast Name

Relationship to Affected Child*

MomDadGrandparentOther

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Best time to reach you

MorningAfternoonEveningI'm a Batten parent, it varies everyday.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Number of Affected Children*

Child 1: Name

First NameLast Name

Child 1: Date of Birth

Date

Child 1: CLN Subtype

Child 1: Date of Diagnosis

Date

Child 1: Are you currently caring for your child, or have they passed?

Currently CaringChild has passed

Child 1: Date of Death

Date

Child 2: Name

First NameLast Name

Child 2: Date of Birth

Date

Child 2: CLN Subtype

Child 2: Date of Diagnosis

Date

Child 2: Are you currently caring for your child, or have they passed?

Currently CaringChild has passed

Child 2: Date of Death

Date

Child 3: Name

First NameLast Name

Child 3: Date of Birth

Date

Child 3: CLN Subtype

Child 3: Date of Diagnosis

Date

Child 3: Are you currently caring for your child, or have they passed?

Currently CaringChild has passed

Child 3: Date of Death

Date

Child 4: Name

First NameLast Name

Child 4: Date of Birth

Date

Child 4: CLN Subtype

Child 4: Date of Diagnosis

Date

Child 4: Are you currently caring for your child, or have they passed?

Currently CaringChild has passed

Child 4: Date of Death

Date

We are excited to have you partner with the BDSRA Foundation as a Fam Fund. We want to make this process as simple and effective as possible for you.

To be ready to set up your page, you will need to have the following items:

Decide on a name for your Fam Fund to represent your child(ren), family, and/or journey. This can be simple, professional, or creative; whatever feels right.
Do you have a logo? No problem if you don’t, we can help with that. Start thinking about colors, themes, and images you might want to incorporate.
Start writing your family bio: This can include information about your family, child, diagnosis, why you are partnered with BDSRA, etc. Anything you want your community to know about can be included here.
Gather some photos to feature on your page.
Decide how you want donations made through your Fam Fund to be directed.

We will be in contatct with you very soon to get the next steps accomplished.

Comments or questions

BDSRA Fam Funds Interest

CONTACT INFORMATION

NEXT STEPS: PAGE SET UP