Gift Certificate

The Gift Certificate Program allows any person in Miami-Dade County with Down syndrome (or their immediate family member) to enter to win a gift certificate in the amount of $300.00 payable to a provider of physical, occupational or speech therapies or other educational services. Four gift certificates are awarded each month. Please refer to the terms and conditions below for a full explanation of the program.

Name * Title First Last Suffix
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Daytime Phone * - (###) - ### ####
Evening Phone - (###) - ### ####
Email *
Person with Down syndrome Receiving Gift
I read/accept the Terms & Conditions * YES
Please check the check box to agree the fact that you have read the terms and conditions. For more information, please click on the link to check for terms and conditions