DSPG Membership Form

DSPG Membership

Welcome! Please complete the following form in order to become a member of the Down Syndrome Parents Group of WNY.
Type of Request*

New MemberCurrent Member - Please update my information
Name*

First NameLast Name
E-mail
Phone Number:

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Newsletter Delivery Preference*
Type of Membership*
Relationship to Person with Down syndrome
Person with Down syndrome's Name

First NameLast Name
Person with Down syndrome's Birth Date:

MonthDayYear
Would you like to receive a new parent folder? This is for parents of babies and toddlers.

No thanksYes!
School District
Select Events of Interest

BowlingDancesHoliday PartiesInformational MeetingsSocial GroupsSpaghetti Dinner & Basket RaffleStep Up for Down SyndromeYoung Athletes
I am interested in volunteering!

Joining the Board of DirectorsPlanning an EventSpaghetti Dinner and Basket RaffleStep Up for Down SyndromeOther
You will receieve confirmation via email after you submit your application. If you have any questions feel free to contact Amy at amonson23@hotmail.com. We look forward to seeing you soon!

Thank you!
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