Membership Application

Thank you for your interest in becoming a member of Down Syndrome NSW!

Individuals may apply for membership in one of two categories.

Ordinary Membership: for a parent, grandparent, sibling, legal guardian or full time carer of a person with Down syndrome.
Affiliate Membership: any person not less than 18 years of age who is not eligible to become an Ordinary member; also a corporation, organisation, trust and any form of legal entity accepted by the Board.

All memberships are set out in the Down Syndrome NSW constitution which you can view online.

Membership Form

Please choose the membership you wish to apply for

Ordinary Membership - Person with Down syndrome

Ordinary Membership - Family Member

Affiliate Membership - Individual

Affiliate Membership - Organisation

Update Membership

Ordinary Membership

Name

First Last

Date of Birth

Email(Required)

Mobile Phone

Home Phone

Address

Street Address Suburb or Town State or Territory Postcode

Do you identify as Aboriginal or Torres Strait Islander?

Yes

I wish to receive

Down Syndrome NSW Newsletter

Details of the person with Down syndrome

Name

First Last

Relationship to You

Date of Birth

Language spoken at home

Is an interpreter required?

Yes

Does the person with Down syndrome live with family or other?

With Family

Other

School attended or workplace if applicable:

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

Yes

Do you wish to nominate other family members for membership (parent, grandparent, sibling, legal guardian or full time carer)?

Please note you must have their consent to submit this application

Yes

Additional Member

Name

First Last

Additional Member Email(Required)

Phone

Name of Person with down Syndrome and relationship to the additional member

Affilliate Membership - Individual

Name

First Last

Phone

Address

Street Address Suburb or Town State or Territory Postcode

I wish to receive

Down Syndrome NSW Newsletter

Affilliate Membership - Organisation

Organisation Name

Organisation Email(Required)

Organisation Address

Street Address Suburb or Town State or Territory Postcode

Primary Contact Details

First Last

Primary Contact Phone

Primary Contact Email

I wish to receive

Down Syndrome NSW Newsletter

Publicity Release

The photograph(s)/video/audio taken of you or what you supply to us will be used for a range of purposes by Down Syndrome NSW.
We use our images to promote the capability and interest of our members, in our newsletters, brochures, leaflets, websites and other media, such as our Facebook and Instagram accounts. The content may also be stored in our digital library.
By reading and giving consent via this form, you are giving your permission for the photograph (s), video, audio to be used by Down Syndrome NSW, for thirty-six (36) months after the date of this digital consent.
Thank you for helping us to show how our Down syndrome community achieve their full potential in all life stages.

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

I give my consent

I do not give my consent

Declarations

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

You can view the constitution via this link

Yes

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

Yes

Comments

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