Register Now | Dementia Friends Hong Kong

Home

Organization Registration

Registration Form

Terms of Confirmation

Registration Form

E-mail Confirmation

Registration Completed

* Mandatory Fields

Name of the Company / Organization / Group

Nature of the Company / Organization / Group

-- Please Select --

-- Please Select -- Government Non-Profit Organization Business Social Organization Political Organization Schools or Education Organization Others

Scale of the Company / Organization / Group

-- Please Select --

-- Please Select -- 1 – 10 11 – 50 51 – 200 200 or above

Contact Person

Name

Gender

Male Female

Telephone

E-mail Address

As the Login Name
If you don’t have email address, please contact us via phone during office hour.

Password

At least 8 characters including both alphabet and number

Password Confirm

Contact Address

Reasons For Registration

（Multiple）

Want to know more about Dementia

To contribute to "Dementia-Friendly Hong Kong"

Support the Hong Kong Alzheimer's Disease Association

Other, please specify:

To help HKADA best utilize resources, please let us know which media you have learnt about Dementia Friends:

-- Please Select --

-- Please Select -- Hong Kong Alzheimer's Disease Association's Website Social Media (e.g. Facebook, YouTube) Dementia Friendly Community Campaign / SWD Project E+ - pop-up health checkup station Day centers of HKADA Events/Talks/Seminars HKADA's newsletter, Friends or Family Company or organization Direct Mail E-mail others

Please specify the selected media:

Hong Kong Alzheimer's Diseases Association use my personal data for sending its service promotion materials.

I Agree I disagree

Hong Kong Alzheimer's Diseases Association use my personal data for sending its educational information and materials.

I Agree I disagree

Hong Kong Alzheimer's Diseases Association use my personal data for sending its fundraising promotions.

I Agree I disagree

Verify code