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Alert Me Band Request

Thank you for supporting New Directions. While we have you here, let's confirm we've got the best contact information for you.

Contact Information

Name

First Name

Last Name

Verify Email

Phone

Address

Address Line 1

Address Line 2

City

State

State/Province

ZIP/Postal Code

Country

Organization/Employer

Gender

Male

Female

How did you hear about New Directions?

Connection to Down Syndrome

Are you a(n)...?

What's your connection to Down Syndrome? Which option best describes your relationship to an individual or people living with Down Syndrome?

Expectant Parent of a child with Down Syndrome

Parent of a child with Down Syndrome

Guardian of someone with Down Syndrome

Friend of someone with Down Syndrome

Grandparent of someone with Down Syndrome

In-Law of someone with Down Syndrome

Relative of someone with Down Syndrome

Sibling of someone with Down Syndrome

Self-Advocate (I have Down Syndrome)

Educator

Service Provider

Tell us about your individual with Down Syndrome!

What's their name, birthday, gender, favorite Disney character, etc?

Their Name

First Name

Last Name

What's their Birthday?

Month / Date / Year

Gender

Male

Female

What else can you tell us about them?

Message or Note

How can we help you?

Are there any immediate questions, concerns, or needs you'd like us to provide assistance with?

Is there anything else you'd like to share?

Thank you

Your submission will send an email to the board of directors, who will reply with a unique coupon code to be used to checkout with your Alert Me Band on their website. Allow us 1-2 days to reply via email.