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Dementia Friends

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A Friend
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Becoming a Dementia Friend

It’s time to become a Dementia Friend. Simply fill in the information below and you’re on your way.

Mandatory fields are indicated by an asterisk (*)

First name is required
Last name is required
Age is required
Gender is required
Email is required
Email already exists
Please enter a valid email address
The emails do not match
Postal code is required

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Motivation is required
Motivation is required

Partner Code

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

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