Down Syndrome Association of the Philippines - Register with Down Syndrome Association of the Philippines!

DSAPI

Tuesday, September 07 2010 @ 03:49 AM GMT+8

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DSAPI Membership Form

Please complete the application below. Once you have completed the application, click the Submit button and the application will be processed immediately. (*Required Fields)

Username: * (used for logging into site)

Last Name

First Name

Middle Name

Nickname

Birth Date

Home Address
Street
City
Province
ZipCode

Email Address

Home Phone No

Fax No

Mobile No

Work Address

Work Phone No

Work Fax No.

Highest Education

School

Name of Spouse
Last Name	First Name	Middle Name	Nickname	Birth Date

Email Address			Mobile No
Work Address			Work Phone No
Work Address			Work Fax No.
Highest Education			School
Special Skills
Word Processing Desktop Publishing Photography Others

I have Down Syndrome I am a parent I am a relative I am a professional., (pls specify: ) None of the Above		Type of Membership Annual (P 300.00 per year) Lifetime (P 5,000.00 donation) Bigger contributions will be most welcome
		Please send me an Application Form for Corporate membership as well
I WOULD BE INTERESTED IN		I WOULD LIKE TO JOIN THE FF COMMITTEES
talking to new parents helping in office work fundraising telemarketing manning hotline service teaching organizing recreational activities	publicity and promotions publications/writing doing research/field work liasing with media doing photography/video work others	Parent Support & Development Health Care Education Guidelines Communication Membership and Hospitality Finance Activities

I WOULD LIKE TO BE IN TOUCH WITH FAMILIES LIVING NEAR ME WITH CHILDREN OF THE SAME AGE Yes No
IF A MEMBERSHIP DIRECTORY IS PUBLISHED, I WISH TO BE INCLUDED Yes No
Name of Child with Down Syndrome	Nick Name	Order of Birth	BirthDate
*	*	*	*
HOW DID YOU KNOW ABOUT THE DOWN SYNDROME ASSOCIATION OF THE PHILIPPINES