Individual Membership

An individual membership is $35 and covers one (1) person. An individual membership is $35 and covers one (1) person. This is for extended family members, supporters of the association and/or professionals.
Applicant Info
Address, City, State, & Zip
Cell Phone
Email (Primary)
Alternate Contact Information
Home Phone
Alternate Phone
Email (Secondary)
Important (Optional) Information

The following information is EXTREMELY IMPORTANT for funding purposes; however, optional and will be kept confidential.  This information is gathered for the purposes of applying for grants, which often times require DSA of NWI & Chicagoland membership data to the grantor to determine and/or approve the Down Syndrome Association as a qualified applicant.

Family Income /year
Please Note:  The DSA of NWI & Chicagoland loves pictures.  We love sharing those pictures with the public (on social media, in newsletters and for marketing purposes) even more! 
Payment Information

If you have any questions please contact the DSA by phone at (219) 838-3656 or email at

Visa MasterCard American Express Discover
? Visa®, Mastercard®, and Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.