Membership Form DSAT Membership Individual who would like to join DSAT First Name Last Name Address 1 Address 2 City State Zip Email Phone Number best contact number I am a(n) Individual w/ Down syndrome Parent of Individual w/ Down syndrome Expectant Parent of a baby w/ Down syndrome Family Member of Individual w/ Down syndrome Member of the community who supports Individuals w/ Down syndrome Professional who works w/ Individuals w/ Down syndrome Please select the option that best fits you Individual w/ Down syndrome If you are a parent, a family member or an individual with Down syndrome, please complete the following for your loved one or yourself. First Name Last Name Date of Birth example: 07/25/2009If child is not yet born, please enter due date Gender Female Male How did you hear about DSAT? Friend/Family Member Medical Professional Website Facebook If other please explain: Please indicate DSAT Programs you are interested in: Please Check all the Apply Buddy Walk Therapy Assistance Support Services Scholarships Talk Tools Hope Haven Down Syndrome Clinic Evaluations Workshops Social Gatherings Families in Need Emergency Funding Please indicate all resources you are interested in: Please check all that apply Prenatal Diagnosis/New Baby Information New to Area Information Research Lending Library Support Groups Area Provider Information Are you interested in volunteering with DSAT? Yes, I'd like to help! Yes, I'd like to help with the Buddy Walk Yes, I'd like to serve on the Board of Directors No, not at this time Please let us know if you have any questions, concerns or ideas! Submit Form