DSAF Infant/Toddler Summer Box Sign-Up
Complete the form below to reserve your DSAF Summer Enrichment Box. Boxes will be reserved on a first-come first-served basis for the first 15 individuals that sign up. Per the stipulations of the grant funding that made this program possible, only Lincoln/Lancaster County families are eligible to apply. Thank you for understanding!

One box per child with Down syndrome per family, please.

Questions? Contact Jamie at director@dsafnebraska.org.
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First Name of Child with Down Syndrome
Last Name of Child with Down Syndrome
Age of Child with Down Syndrome
Parent/Guardian Name
Parent/Guardian Email
Parent/Guardian Phone
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