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Member Application

NDAC Membership Application

By completing this form, I acknowledge that I have read and understand the NDAC Terms of Membership.

I have read and understand the NDAC Terms of Membership
I am joining NDAC:
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Fill this out if you selected 'On behalf of a group'
Fill this out if you selected 'On behalf of a group'
Fill this out if you selected 'On behalf of a group'
Country
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I give permission for NDSC to list my group on the NDSC website and in other materials as an NDAC Member
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About You

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Last Name *
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City *
State/Province *
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If you do not know, please visit the link: www.house.gov/representatives/find-your-representative

Connection to Down syndrome or disability community

I am a:
Do you have a support person who should be included in NDAC communications?
I have reviewed the NDAC Terms of Membership and agree to become an NDAC Member
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