Become a member

Your support is essential to us so that the cause of people living with DLD is heard.

Becoming a member means expressing your support and interest in the DLD. For our
charity organization, this helps to strengthen our actions to raise awareness among the
various levels of government in order to expand and improve the range of services
offered. Many of the association’s activities are exclusive for members, so it is important
to have a valid membership.
You must print the form below (PDF) and return it to us by mail or email with your
payment. You can pay by cheque or online by PayPal or credit card.
If you are having difficulty uploading a document or completing the electronic form,
please contact us at: 450-635-1961 or by email at: info@dysphasiemonteregie.org.
We count on your participation, to be able to strengthen our organization and achieve
our common goal, to help as many people as possible with the means at our disposal.
Please keep in mind that our association is a non-profit organization, managed and
operated by people like you, who face the same challenges as you, who have the same
concerns and goals.
Thank you for your involvement!

For business people, corporations, levels of government and various organizations:
By joining our association, you provide unwavering support to advance and promote the
cause of the DLD and encourage other organizations and corporations to do the same.
Please keep in mind that our association is a non-profit organization and, by the same
token, we play a role of information, awareness and support agent for people living with
DLD and their entourage.

Together, we can make a difference!

Download this registration form

Or complete the online form

Choix obligatoire(Required)
Choix obligatoire(Required)
Pour les ré-inscriptions seulement.
Identité(Required)
Adresse(Required)
Courriel(Required)
Insérez votre adresse courriel afin que l'on puisse vous envoyer une confirmation de votre inscription.
Suivi d'une * si l'enfant est dysphasique.
Suivi d'une * si l'enfant est dysphasique.
(Required)
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Méthode de paiement*
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Supported Credit Cards: MasterCard, Visa