Association For Persons With Disabilities - Free State, South Africa

Become a Friend

Title

Name & Surname

Disability (If Applicable)

Contact Number

E-Mail Address

Postal Address

How did you hear about APD-FS?

Would you like to become a volunteer at APD-FS?

Yes
No

Would you like become involved with a certain Project, Division, Department, etc?

Yes
No

Would you like to make a donation and/or sign a debit order?

Yes. Please contact me
No. Thank you

Would you like be kept informed about APD-FS events?

Yes
No

Do you have any friends or family with a disability that we can contact?

Yes
No

If "Yes", please provide us with their contact details:

Name & Surname 1

Tel / Fax / E-Mail

Name & Surname 2

Tel / Fax / E-Mail

Name & Surname 3

Tel / Fax / E-Mail