VIP Form

Calling all VIP's!!! Are you an individual with Down syndrome? We want to Celebrate you as a VIP at our 3.21 For Life Celebration!!! As a VIP you will receive a special swag bag and a t-shirt to wear at the event. Please fill out the information below.

Name of Person Completing the Form

First Name

Last Name

Phone

(###)

###

####

Your Relation to Individual with Down syndrome

(if applicable)

Name of the VIP

(Individual with Down syndrome)

First Name

Last Name

Birth Date of VIP

YYYY

What town/city do you live in?

School District of VIP

(if applicable)

Tshirt Size of the VIP

VIP Form

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