Down Syndrome Association of Central Oklahoma - 2022 Bountiful Blessings Calendar Application

* Parent or Legal Guardian Name

* Applicant’s Name Please enter how you would like it to appear in the calendar

* Date of Birth

Siblings Please include their name(s) and age(s)

* Street Address

* City

* State

* Zip

* Email Address

* Phone Number

Are you of Hispanic, Latino, or of Spanish origin?

Yes
No

How would you describe yourself?

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

If you answered American Indian or Alaska Native, please list your tribal affiliation

* Please list the DSACO activities and programs or disability advocacy in which you have been involved in and describe how it has impacted your life/family.

* In 25-100 words, tell me about your child. Examples might be community involvement, extracurricular activities, favorite things your child likes to do with his/her family, favorite book, etc. Include anything that highlights their ability and personality.

If you would like to be featured as a profile, please attach 1-2 paragraphs about the applicant’s recent achievement(s).

* Are you willing to help secure a calendar sponsor or commit to selling a minimum of 25 calendars? The annual calendar is an important awareness piece, but it is also a fundraiser for DSACO. If your child is selected to participate in the calendar, you are committing to purchasing/selling one box of calendars OR securing a sponsorship of $500 or more.

Yes
No

DSACO is seeking companies or individuals to sponsor a month in the calendar. Cost per page is $1000 or $500 to co-sponsor a month (tax deductible). If you know of anyone who would be interested, please list them.

Please upload a recent photo that is representative of your child.

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