2021 DSDN Rockin' Family Fund Adoption Grant Request
Please complete this form if interested in receiving a DSDN-provided adoption grant. The DSDN Rockin' Family Fund makes this opportunity possible (https://www.dsdiagnosisnetwork.org/rff-rockinfamilyfund).

Because of incredible support DSDN received, we are able to provide 1 adoption grant to a DSDN family who adopted a child with Down syndrome who is under the age of 4 as of October 31, 2021, between November 1, 2020, and August 1, 2021. Qualified applicants must currently:

- be a member of the DSDN Adoption & Ds online support group by August 1, 2021
- be a US citizen
- have received placement of a child with Down syndrome
- be past the revocation period of placement

One entry per person. This grant is not transferable. Review the full terms and conditions here: https://docs.google.com/document/d/15S79c_cHTZkkKU202VjCY2GXrja-Iv0LUuB7dXsBOyo/edit?usp=sharing

Applications will close at midnight CDT, on August 1, 2021. DSDN will contact and announce the randomly chosen winner on August 2, 2021. To support our DSDN mission, the winner must be a member of the DSDN Adoption & Down syndrome group. Adoption grants are limited to one winner per family per calendar year.

If you have any questions, please contact Family Support Director Christy Cooper at christy@dsdiagnosisnetwork.org
Are you a member of the DSDN Adoption & Down syndrome Facebook group? *
To support our DSDN mission, the winner must be a member of our Adoption & Down syndrome group and be adopting a child with Down syndrome who will be under 4 as of 10/31/2021. To join our Adoption & Down syndrome group and/or a DSDN Birth Group, visit the following website https://www.dsdiagnosisnetwork.org/connections. Once done, return to complete your scholarship application.
Will your child with Ds be under the age of four as of 10/31/21? *
To support our DSDN mission, winners must be members of a DSDN Group with a child under 4 as of 10/31/21.
What is your child's birthdate (with Down syndrome)? *
To support our DSDN mission, winners must be members of a DSDN Group with a child under 4 as of 10/31/21.
Did you complete the adoption and pass the revocation period of placement between November 1, 2020, and August 1, 2021? *
Your name *
Your Facebook name, if different from above *
Email address *
Make sure to use an email you check regularly since we will use this to communicate details of the scholarship.
Phone number *
We will text the winners, so be sure to check your texts on August 2!
Street address *
City, State *
Zip code *
I agree to the DSDN terms and conditions outlined in the introduction to this form. *
See the very top of this form for the link to the terms and conditions.
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