Name *

First Name

Last Name

Phone

(###)

###

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Tell us a bit about you:

Tick the responses that apply to you

Are you living with dementia?

Are you currently caring for someone with dementia?

Have you previously cared for someone or had experience with people living with dementia

If you are able to volunteer, please let us know if you have preferred activities to be involved in

Gardening and maintaining the grounds

Arts and crafts

Attending workshops

Administrative or tech help.

Assisting with events and activities.

Supporting carers and their loved ones as a Care Mate (previous caring experience required) or a Care Bestie (volunteer role for youth aged 12-18 years)