The Down Syndrome Association of Greater Charlotte Membership Form
Welcome! Thank you for joining the Down Syndrome Association of Greater Charlotte! The DSAGC offers trained parent mentors to families who recently received a Down syndrome diagnosis (please email NewBaby@dsa-gc.org for more info). We also have small support groups, educational meetings, symposiums and conferences in addition to a few camps and fun events! Please fill in your information below. You will be added to our postal mail and e-mail distribution lists within a couple of weeks. You can also keep up with the latest news and events on our Facebook page: www.facebook.com/DSAGreaterCharlotte/!
First Name
Your answer
Last Name
Your answer
Street Address
Your answer
City, State, and Zip
Your answer
Which County do you live in (not Country)?
Your answer
Email Address
Your answer
Full name of individual with Down syndrome
Your answer
Birth date of individual with Down syndrome
MM
/
DD
/
YYYY
Primary Language
Your answer
Race
If Other, please list
Your answer
What school does your child attend or will they attend when they start school?
Your answer
How would you prefer to receive our newsletter?
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