MEMBERSHIP APPLICATION

Thank you for your application to become a member of Down Syndrome NSW Association Inc.

We strongly encourage all people with Down syndrome to become members in their own right. We also offer memberships for family members, supporters and organisations.

Our membership is free and you can join by completing the membership form below.

Please choose the membership you wish to apply for: *

Ordinary Membership - Person with Down syndrome Ordinary Membership - Parent/Carer/GuardianOrdinary Membership - SiblingOrdinary Membership - GrandparentAffiliate - IndividualAffiliate - Organisation

First Name *

Last Name *

Date of birth: *

Email Address *

Phone number: *

Address: *

Street address *

City *

State *

Postcode *

If other is checked above please state your relationship to your loved one with Down Syndrome.

Are you of Aboriginal and/or Torres Strait Islander origin? *

NoYes, AboriginalYes, Torres Strait IslanderYes, both Aboriginal or Torres Strait Islander

I wish to receive:

Down Syndrome NSW Newsletter

Please note : a person with Down syndrome, parent, grandparent, sibling, legal guardian or full time carer of a person with Down syndrome will be offered Ordinary membership with Down syndrome NSW following the submission of MEMBERSHIP APPLICATION
If you selected other you will be granted Affiliate membership with Down Syndrome NSW and you must be 18 year old or older as per the Down syndrome NSW constitution.

Both memberships allow you to access to member benefits with Down Syndrome NSW.

Details of the person with Down syndrome.

Name:

Relationship to you:

Date of birth:

Language spoken at home:

Is an interpreter required:

Does the person with Down syndrome live at home with family?

Is the person of Aboriginal and/or Torres Strait Islander origin? *

NoYes, AboriginalYes, Torres Strait IslanderYes, both Aboriginal or Torres Strait Islander

Are you also applying for the family member with Down Syndrome to be nominated for membership of Down Syndrome NSW?

I have read the above information and consent to the person mentioned in this form being photgraphed, filmed and/or audio recordings used by Down Syndrome NSW for various purposes. This may include but it not limited to: newsletters, media release, social platforms and website. *

YesNo

By submitting this Membership Request I am consenting to receiving marketing communications from Down Syndrome NSW from time to time. I understand y contact details will not be shared with any outside organisations.

How did you hear about Down Syndrome NSW? *

I confirm I am eligible for membership per the requirements set out in the Down Syndrome NSW Constitution *

I confirm I have the consent to share the personal information listed in this form