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Lanterman Sign Up Information

Last Updated:
1/6/2020 1
Site Encrypted:
Yes
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Email Verified:
70/100
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Email Address

 Email

Date of Birth

 

Your Name

 First Name, Last Name

Your Address

 Home Address, City, State, Region, Country, Zipcode

Phone Number

 Phone

Post-Registration Data

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Membership Emails

Below is a sample of the emails you can expect to receive when signed up to Lanterman.

Your subscription to our list has been confirmed.

For your records, here is a copy of the information you submitted to us...

Email Address:@
First Name:Emily
Last Name:Taylor
Organization:Jon
Address:128 Langham Road
219 Langham Road
London, Jon 90275 Kuwait
Phone Number:07949480693
Year of Birth:1,992
Gender:Female
Other Disability:Jon
Subscription Preferences:: Los Angeles Region, Foothill Region (Glendale, Burbank, La Caņada), Pasadena Region

If at any time you wish to stop receiving our emails, you can:
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You may also contact us at:
kyrc@lanterman.org



Email Marketing Powered by Mailchimp
Registration
Organization:
First name
Last name
Email
Phone
Home address
City
State
Region
Country
Zipcode
Date of birth
Gender
USA
Gender:
Female 
Male Subscription Preferences: In addition to General Lanterman News and Alerts, we occasionally send out more specifically targeted information. Please check all topics of interst to you, below.
General Lanterman News and Alerts
Service Provider Newsletter
Legislative Issues
Perspectives International Film Festival: News & Announcements Age-Specific:
Early Intervention (birth to 3)
School-Age (3 to 14)
Young Adult (14 to 18)
Adult (18 plus)
Older Adult (45 plus) Disability-Specific:
Autism
Cerebral Palsy
Down Syndrome
Epilepsy
Region-Specific:
Los Angeles Region
Foothill Region (Glendale, Burbank, La Cañada)
Pasadena Region Email Format:
html
Data Name Data Type Options
Organization:   Text Box
First name   Text Box
Last name   Text Box
Email   Text Box
Phone   Text Box
Home address   Text Box
City   Text Box
State   Text Box
Region   Text Box
Country   Text Box
Zipcode   Text Box
Date of birth   Text Box
Gender   Text Box
  dropdown USA
  option Gender:
  option Female 
  checklist Male Subscription Preferences: In addition to General Lanterman News and Alerts, we occasionally send out more specifically targeted information. Please check all topics of interst to you, below.
  checklist General Lanterman News and Alerts
  checklist Service Provider Newsletter
  checklist Legislative Issues
  checklist Perspectives International Film Festival: News & Announcements Age-Specific:
  checklist Early Intervention (birth to 3)
  checklist School-Age (3 to 14)
  checklist Young Adult (14 to 18)
  checklist Adult (18 plus)
  checklist Older Adult (45 plus) Disability-Specific:
  checklist Autism
  checklist Cerebral Palsy
  checklist Down Syndrome
  checklist Epilepsy
  checklist Region-Specific:
  checklist Los Angeles Region
  checklist Foothill Region (Glendale, Burbank, La Cañada)
  option Pasadena Region Email Format:
  option html

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Comment on: 01/09/2020