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The password must have at least 8 characters, at least 1 digit(s), at least 1 lower case letter(s), at least 1 upper case letter(s), at least 1 special character(s) such as *, -, or #
Password
Email address
Email (again)
First name
Last name
City/town
Country
Select a country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (the Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (the Democratic People's Republic of)
Korea (the Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (the Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Tell us about your dementia care role
Tell us about your dementia care role
Tell us about your dementia care role
Your role
Health Care Provider
Family Caregiver
Person with Dementia
General Public
First Responder
Service Sector
Alzheimer Society Staff / Volunteer
Other
Health Care Provider Role
None
Personal Support Worker
Social Worker / Social Service Worker
Case Manager
RN / RPN
OT / PT / OTA / PTA
Recreation
Other
Privately Paid Caregiver
Primary Field of Employment
Retirement Home
Acute Care / Hospital
Supportive Housing
Long-term Care
Community Agency
Other
None
Name of Employer
First Responder Role
None
Fire
Paramedic
Police
Other
Service Sector
None
Recreation
Retail
Library
Restaurant
Other
Service Sector Position
None
Staff
Temporary employee (contract, intern, co-op student, etc.)
Volunteer
Board member
Leadership (director, owner, manager, supervisor, etc.)
Other
Society
None
Alzheimer Society of Canada
Alzheimer Society of Alberta and Northwest Territories
Alzheimer Society of British Columbia
Alzheimer Society of Manitoba
Alzheimer Society of New Brunswick
Alzheimer Society of Newfoundland and Labrador
Alzheimer Society of Nova Scotia
Alzheimer Society of Ontario
Alzheimer Society of Prince Edward Island
Alzheimer Society of Quebec
Alzheimer Society of Saskatchewan
Brant, Haldimand Norfolk, Hamilton Halton
Chatham Kent
Cornwall and District
Dufferin County
Durham Region
Elgin-St. Thomas
Grey-Bruce
Hastings - Prince Edward
Huron County
Kenora / Rainy River Districts
Kingston, Frontenac, Lennox and Addington
Lanark Leeds Grenville
Muskoka
Niagara Region
Peel
Perth County
Peterborough, Kawartha Lakes, Northumberland, and Haliburton
Sarnia-Lambton
Sault Ste. Marie and Algoma District
Simcoe County
Southwest Partners
Sudbury-Manitoulin North Bay and Districts
Thunder Bay
Timmins-Porcupine District
Toronto
Waterloo Wellington
Windsor-Essex County
York Region
Abitibi-Témiscamingue
Bas-Saint-Laurent
Centre-du-Québec
Chaudière-Appalaches
Côte-Nord
Estrie
Gaspésie–Îles-de-la-Madeleine
Granby et Région
Haut-Richelieu
Lanaudière
Laurentides
Laval
Maskoutains-Vallée des Patriotes
Montréal
Outaouais
Québec
Rive-Sud
Saguenay-Lac-Saint-Jean
Suroît
Other Dementia Care Role
Alzheimer Society Role
None
Board Member
ED/CEO
Manager
Programs (e.g. First Link, Education, Support, Soc Rec)
Fund Development
Volunteer
Other (please specify)
Other Alzheimer Society Role
Your Alzheimer Society affiliation
Your Alzheimer Society affiliation
Your Alzheimer Society affiliation
Your regional Alzheimer Society
Alzheimer Society of Canada
Alzheimer Society of Alberta and Northwest Territories
Alzheimer Society of British Columbia
Alzheimer Society of Manitoba
Alzheimer Society of New Brunswick
Alzheimer Society of Newfoundland and Labrador
Alzheimer Society of Nova Scotia
Alzheimer Society of Ontario
Alzheimer Society of Prince Edward Island
Alzheimer Society of Quebec
Alzheimer Society of Saskatchewan
Not Applicable
Which local Ontario society chapter is nearest you?
None
Brant, Haldimand Norfolk, Hamilton Halton
Chatham Kent
Cornwall and District
Dufferin County
Durham Region
Grey-Bruce
Hastings - Prince Edward
Huron Perth County
Kenora / Rainy River Districts
Kingston, Frontenac, Lennox and Addington
Lanark Leeds Grenville
Muskoka
Niagara Region
Alzheimer Society®, Serving Communities in Ottawa and Renfrew County
Peel
Peterborough, Kawartha Lakes, Northumberland, and Haliburton
Sarnia-Lambton
Sault Ste. Marie and Algoma District
Simcoe County
Southwest Partners
Sudbury-Manitoulin North Bay and Districts
Thunder Bay
Timmins-Porcupine District
Toronto
Waterloo Wellington
Windsor-Essex County
York Region
Which local Quebec local society chapter is nearest you?
None
Abitibi-Témiscamingue
Bas-Saint-Laurent
Centre-du-Québec
Chaudière-Appalaches
Côte-Nord
Estrie
Gaspésie–Îles-de-la-Madeleine
Granby et Région
Haut-Richelieu
Lanaudière
Laurentides
Laval
Maskoutains-Vallée des Patriotes
Montréal
Outaouais
Québec
Rive-Sud
Saguenay-Lac-Saint-Jean
Suroît
Customize your Notifications
Customize your Notifications
Customize your Notifications
I would like to receive Alzheimer Society updates (i.e. education/ learning opportunities, newsletter, etc)
I give my permission to be contacted by an Alzheimer Society staff member to learn about more Alzheimer Society supports and services.
I give my permission to be contacted by an Alzheimer Society staff member to learn more about dementia-friendly communities
Your mailing address
Your mailing address
Your mailing address
Province
AB
BC
MB
NB
NL
NT
NS
NU
ON
PE
QC
SK
YT
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Other
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