Family Support Network Opportunities
Thank you for your interest in Family Support Opportunities
Please fill in the form below and once received, a member of our staff will contact you with additional information.
Thank you!
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I would like to help Family Support Network of the Sandhills by... (check ALL that apply)
* Become a Member of Your Advisory Council
* Become a Member of the SAND Planning Committee
* Support Your Annual FSN Sandhills Program Awareness Drive
* Be a Support Parent for Other Families in Need of Help and Support
* Donate My Gently Used Books for Your Lending Library
* Supply a Snack for Your PAC Meetings
* I Can Interpret for Non-English Speaking Families
* Help You Organize Family Events
* Donate Office Supplies
* My Time! Whatever You Need Help with.
OTHER:
Your Contact Information
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First Name
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Last Name
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Are you representing as a ...?
Parent
Professional
Both
If Professional, please state your position.
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Address 1
Address 2
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City
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State
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Zip
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Phone
Alternate Phone
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Email Address
Children's Information
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Relationship to Children:
I do not have a child with Special Needs
Mother
Father
Guardian
Other
Child #1 Name
Age
Child's Diagnosis
Child #2 Name
Age
Child's Diagnosis
Child #3 Name
Age
Child's Diagnosis
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Indicates Response Required
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