Down Syndrome Association of Polk County

Name:
Address:
City:
State:
Zip:
Telephone:
Email Address:
Interest:  
  I have a family member with DS
  I work with children and/or adults with DS
  I would like to help as a volunteer

If you are a parent or guardian of someone with DS, please tell us a little bit about them:

What age is the child with Downs?
What kind of activities do they enjoy?
What school do/did they attend?

Are you interested in joining a local support group?

Yes    No   Maybe

If so, when would be the best time to meet?

Comments:

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