Membership Information Update

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Need to update your DSAWM family membership information? Please do so using the form below or by calling our office at 616-956-3488.

Membership Information Update

General Information
Parent/Caregiver Name*
First Last
Spouse/Partner
First Last
Address*
Street Address City State ZIP Code
County
DSAWM uses this information for programming and grant purposes.
In what county do you reside?
School District
DSAWM uses this information for programming and grant purposes.
Primary Email*
Secondary Email
Primary Phone #*
Secondary Phone #
Individual with Down syndrome Information
If more than 2 individuals with Down syndrome, please add the name, gender, and birthdate of any other individuals in the Additional box below.
Name of Individual with Ds*
First Last
Gender*
- Male
- Female
Birthday*
Which of the following best describes the individual with Down syndrome?*
- Asian or Pacific Islander
- Black or African American
- Hispanic or Latino
- Native American or Alaskan Native
- White or Caucasian
- Multiracial or Biracial
- Other
- Prefer not to answer
Other (please describe)
- Add another individual with Down syndrome
Name of Second Individual with Ds
First Last
Gender
- Male
- Female
Birthday
Which of the following best describes the individual with Down syndrome?
- Asian or Pacific Islander
- Black or African American
- Hispanic or Latino
- Native American or Alaskan Native
- White or Caucasian
- Multiracial or Biracial
- Other
- Prefer not to answer
Other (please describe)
Additional Individuals with Ds
Member Permissions
Contact Permission*
- I give DSAWM permission to contact me via email (newsletter, event & program information, etc.)
- I do not want to receive information from DSAWM.
Photo Consent*
DSAWM photographs participants at many member events, activities, and gatherings. Additionally, each year DSAWM sends out a call to members for their own photo submissions. Photos may be used in marketing and promotional materials, the DSA Press newsletter, social media, or on the DSAWM website.
- I give permission to the DSAWM to use photos of me, my child and/or my family
- I do NOT give permission to the DSAWM to use photos of me, my child and/or my family
Volunteer Opportunities
Our volunteer opportunities range from one-time projects to ongoing working committees. Please share how you are interested in helping and we will contact you with more information.
- Events
- Programs
- Parents for Parents Mentoring
- Community Relations/Outreach

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Membership Information Update

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Membership Information Update

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Individual with Down syndrome Information

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