Dementia Friends Canada

Mandatory fields are indicated by an asterisk (*)

First Name*

First name is required

Last Name*

Last name is required

Age is required

Gender is required

Email*

Email is required

Email already exists

Please enter a valid email address

Confirm Email*

The emails do not match

Postal Code*

Postal code is required

Click Here for additional options

Show Less

How did you learn about Dementia Friends Canada?

Do you work for any of these organizations that are already Dementia Friends?

Do you currently volunteer with an organization and/or a charitable campaign? If so, what is the cause?

What is your motivation for signing up?

Motivation is required

Other Motivation

Motivation is required

Language Preference

Thank you for becoming a Dementia Friend. A benefit of being a Dementia Friend member is that you may receive information about local resources, and other perks from Dementia Friends Canada and/or your local Alzheimer Society. You may opt out at any time.

Partner Code

If you have been given an partner code, please enter it here.

Submit

In order to continue to step 3, please review the registration form to ensure all mandatory fields are completed in full.

Becoming a Dementia Friend

Partner Code