Join The ACT DSA

 

ACTDSA Membership Application Form

There are many benefits of being an ACTDSA Member. To join, please complete the form below and press the submit button.

You will not be required to make payment online, because we do not yet have that facility available. Instead, our Office will contact you to confirm the details of your membership and to tell you how to make your payment.

The first half of the form is all you need to complete to get your membership underway: however, we would be very grateful if you would take a few extra minutes to let us know some additional information about your family’s interests. This will help us to be more responsive to the needs and interests of our members.

We look forward to welcoming you as a member of the Association!

Membership Type Required
Family or individual-$50 (Please complete Part A and Part C below)Organisational-$100 (Please complete Part A and Part C below)Concessional-$15 Please note: Concessional Membership is only available to people over 18 with Down syndrome. (Please complete Part B and Part C below)

 

Part A

Applicant(s) Full Name

Relationship to Person with DS

Name of Person with DS

Date of Birth of Person with DS

Family Member / Organisation Postal Address

Mobile/Telephone (business hours)

Mobile/Telephone (after hours)

Email Address

Second Email

Part B (for people over 18 with DS)

Applicant’s Name

Date of Birth

Applicant’s Postal Address

Applicant’s Mobile /Telephone

Applicant’s Email Address

Member of Confident Speaker Program?

YesNo

Name of Responsible Adult/Carer

Relationship to Person with DS

Responsible Adult/Carer’s Phone(s)

Responsible Adult/Carer’s Email(s)

 
Your above application will now be presented to the ACTDSA Committee members at the next scheduled ACTDSA General Committee meeting. Once approved, we will contact you with a request for membership fee payment. In the meantime we will provide you with any support material or assistance that will benefit you as you await this processing formality.

 

Part C

In the meantime, we would be grateful if you could take a few extra minutes to let us know a little more about you and your family.

What activities would you be interested in the DSA organising, hosting and/or sponsoring?

What are your main areas of interest in relation to Down syndrome? (ie particular life transitions? Age-related issues? Social aspects?)

Please indicate those areas you would like to receive information about:
Education – PrimaryEducation – Early learningEducation – High SchoolEducation – Vocational Training and ApprenticeshipsEducation – UniversityEmploymentIndependent LivingLegal IssuesBehavioural Issues and StrategiesDepression and AnxietyAutism Spectrum DisordersSleepBreastfeedingToilet trainingSporting OpportunitiesDanceMusicMoviesArtsConfident SpeakersRecent ResearchConferences and WorkshopsParent RetreatsRespiteAgeing and Down syndromeNDIS

 

What skills would you like to bring to the ACTDSA? We understand that not everyone has time to commit in a major way, but if you have a particular skill set or willingness to commit to the Association in some small way on a regular or irregular basis, we would be hugely grateful (eg. committee membership, new parent or member support, workshop assistance, graphic design, event assistance eg sausage sizzling or face painting, fundraising skills, grant writing, attendance/participation at ACTDSA functions, etc).

Thank you for taking the time to complete this part of the application process.