One moment please...
Last Name
*
First Name(s)
*
Grandchild with Down Syndrome's Name
*
Current Age of Grandchild with Down Syndrome
*
Grandchild with Down Syndrome Birthday
*
(mm/dd/yyyy)
Gender of Grandchild with Down Syndrome
*
Female
Male
Ethnicity of Child with Down Syndrome
*
select one
American Indian or Alaska Native
Asian
African American
Caucasian
Hispanic or Latino
Other
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
*
Second Email Address
We will add this to our email list
Verify Email
How would you like to receive our quarterly newsletter?
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Email
Mailing Address
Phone
*
How did you hear about EIDS?
*
Please check all that apply
Word of mouth
Doctor's office
Social media
News/TV
Other
These are areas we need volunteers; please check if you would like to help with any of these:
*
Please check all that apply
Dash for Downs
Down Syndrome Education
Age Groups
Social Media
Advocacy
Other (explain below)
Other Volunteer Interests
*