Membership Application

Annual Membership

New individual, family or professional membership with the Down Syndrome Aim High Resource Center (DSAHRC).

	Family Membership - $ 25.00 Family Membership
	Professional Membership - $ 25.00 Non-Related Membership, if you do not have a direct relationship with an individual with Down Syndrome.
	Self-Advocate Membership - $ 10.00 Self Advocate Membership

	I would like to submit payment by Check.
Email Address *

Membership Registration

Complete this online form for your annual individual, family or professional membership

with the Down Syndrome Aim High Resource Center (DSAHRC).

Self-Advocates - Individuals with Down syndrome over the age of 16, should register for a Self Advocate membership.

Confirm Membership Type *	Select membership type: Individual, Family, Professional or Self-Advocate.
First Name *
Last Name *
Gender	Female Male ( unselect )
Address *
City *
State *
Postal Code *
Phone (Home) *
Phone (Work)
Member's Name	If you are registering as a Parent, Sibling, Relative or Friend of an individual with Down syndrome, enter his/her full name here. Even if he/she is not currently a member of DSAHRC.
Your Relationship *	What is your relationship to an Individual with Down syndrome? You may Enter: Parent, Sibling, Grandparent, Relative, Friend or None.
News & Notes Newsletter *	Select how you would like to receive the News & Notes Newsletter
No Bulk Emails (User Opt Out)	Excludes "News & Notes" if selected above.