Self-Advocate Listing Request Form Self-Advocate Listing Form First Name* Last Name* Contact Name E-mail* Website Page name Notes* Document (Microsoft Word or .PDF file) Upload Photo (.jpg, .jpeg, or .gif photo/logo) Upload If you prefer - you can send attachments to Stephanie.Holland@DOWNsTownMall.com Self-Advocate Agreement I represent a business owned by a person with Down syndrome (alone or with others). I authorize listing that business on DOWNsTownMall.com I agree to the terms of this agreement.* Yes Submit