Become a DSANV Member
Please provide as much information as you'd like to share with us so we may better serve you as a DSANV member
Email *
First Name *
Middle Name
Last Name *
Address Line1
Address Line2
Postal Code
Phone Number *
Email *
How are you related to someone with Down syndrome?
Clear selection
Please list the names of your children using the following format: Child 1: name, Child 2: name, etc.
Please list the birthdates of each child using the following format: Child 1: birthdate, Child 2: birthdate, etc.
Please indicate whether or not the children's names you listed above have Down syndrome. *
Has Down syndrome
Does Not have Down syndrome
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8
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