Family Membership

Joining the Smith-Magenis Syndrome Foundation enables us to support the family and friends of those with SMS. We also welcome professional memberships from any professionals who have an interest in supporting SMS.

Join us now

Generated with MOOJ Proforms Basic Version 1.3
Your Name: Please enter the family/carer's name here:
First Line Address: Please enter your house number/name and first line of your address.
Second Line Address: Please enter the second line of your address.
Town: Please enter the Town.
County: Please enter the County here.
Postcode: Please enter your postcode here.
Phone Number: Please enter your phone number including area code here.
Your Email Address: Please enter your email address here.
Name of SMS child or adult: Please enter the name of your SMS child or adult here.
Please specify your relationship to SMS child/adult: Please specify your relationship to SMS child/adult (for example daughter, son, sister etc)

 

 

Age when diagnosed: Please enter the date of the child when diagnosed with SMS.
Your Child's date of birth: Please select your child's date of birth.
Month: Please select the month of the date of birth.
Year: Please enter the year of your date of birth.

 

 

Sex: Please select either male or female.
Male:
Female:

 

 

Membership Type: Please select the type of membership you would like to have
Family Membership
Professional Membership

 

 

 

As part of the Smith-Magenis Syndrome Foundation, we offer support to our members, please select if you happy to be contacted by other member or you would prefer not to be contacted.

 

Contact
Please Contact
Prefer No Contact

Additional information