CIDSO APPLICATION FORMS

Initial & Annual Renewal Membership Application

Membership in the Central Illinois Down Syndrome Organization (CIDSO) is open to anyone over age 18 who is a member of a family which has/had a child with Down syndrome, lives within McLean County, IL, and meets other eligibility requirements which are outlined in our bylaws. Any person(s) wishing to apply for membership who do not meet these requirements may be eligible for a membership requirement waiver. Any person(s) wishing to obtain or maintain membership must complete this form on an annual basis every January.

Person in Household / Family with Down syndrome

* Full Name

* Date of Birth

Household / Family Primary Contact Information

* Full Name

* Relationship

If Other, please specify:

* Address

* City

* State

* Zip Code

* Email

Telephone

All individuals seeking membership will be sent emails / mailings pertaining to the business of CIDSO. CIDSO also forwards information from national / state / local groups pertaining to individuals with Down syndrome and disabilities.

Yes, I have read and understand the above.

Photos taken at CIDSO events WILL be shared internally, not publicly, with our membership electronically. I agree that CIDSO may use photographs of me and my family (including minor children) with or without my name.

Yes, I have read and understand the above.

Do you give consent to have your child's image used for any public purpose, including but not limited to the CIDSO webpage, the CIDSO public Facebook page, and publicity pieces such as posters or brochures?