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Please check one:
Parent
Professional
Other
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| Yes, I would like to: |
Receive our Down's Update newsletter?
Yes
No
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Receive telephone calls informing you of upcoming events?
Yes
No
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Receive information about research studies being conducted?
Yes
No
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| The following information is optional. It is used for DDSA planning and informing you of upcoming events. All information is confidential. |
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Name of Child(ren) with Down Syndrome:
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| Birthdate (mm/dd/yyyy):
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| Other Children and Ages: |
| Child(1) Name:
Age:
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| Child(2) Name:
Age:
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| Child(3) Name:
Age:
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| Child(4) Name:
Age:
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School:
Public Board
Separate Board
Other
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School Board:
Durham
Kawartha-Pine Ridge
Other
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Type of Class:
Mainstream
Self-Contained
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Parents who would like to talk to other parents about various concerns somtimes contact us. If you are willing to share your experiences with another family, please list some topics that are important to you (i.e., heart surgery, hearing aids, prenatal testing). May we provide your home telephone number to parents or caregivers needing support in these areas?
Yes
No
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As the DDSA tries to broaden the activities we offer, we are often in need of people with areas of expertise to offer some assistance. For example: web page desing, typing, organizing games at a party, carpentry, accounting, designing or printing brochures, fund raising. Do you have an area of interest/expertise that you would be willing to share on an occasional basis?
Yes
No
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Area of interest/expertise:
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