CMDSS Family Survey
Parent/Guardian Names:
Address: Zip Code:
Home Phone: Cell Phone:
Employment (Him): Employment (Her):
Work Phone: Work Phone:
EMail: EMail:
Child w/ D.S: Child's Birthdate:
Siblings: Siblings Birthdates:

What specific type of activities/educational seminars/field trips, etc. would you like to see CMDSS offer?

We need volunteers!!! Many hands make light work.  Please check all the areas that you are interested in helping out with or any skills/talents that you have that can help.

CMDSS Board
I am interested in becoming a CMDSS Board Member.

Buddy Walk
Co-Chairman
Sponsorship Committee
Marketing/PR Committee
Distributing Brochures
Set-up/Break-Down Committee
Door Prize Committee
Logistics/Registration Committee

Communications
Help with mailings
Phone Tree

Spring/Summer/Winter Socials
Chairperson
Committee

Educational Seminars
Chairperson
Committee

Teen/Young Adult Activities
Chairperson
Committee

Special Talents/Interests/Contacts
Web Page Design/Hosting
Secretarial/Typing
Grant Writing/Marketing/PR
Food/Catering
Media Contacts
Banking/Financial
Print Layout/Design
Other (enter notes below)

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Call 601.397.3696 or EMail info@cmdss.org for more information
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