SDAA Application Form

Name of your organisation

Type of Organisation

If other, please provide details below

Approximately how many employees/members do you have? (This is to help us understand the approximate size of your organisation)

Please insert a link to your organisation's website

Please describe your organisation to us. e.g What does it do, who does it exist for etc

Who will be the main point of contact for your membership application?

What is their job role?

What is their email address?

What is the applicant's contact phone number?

What is the organisation's address?

Why is your organisation interested in becoming a member?

What steps could you take to be more dementia friendly?

Would you like us to send you an example Action Plan form along with the one for your organisation to fill in? Yes please! No thank you

We usually show our list of alliance members publicly. Please read the three statements below and tick any that apply to your organisation, to show that you give consent to the following publicity options. Are you happy to be included in our public list of members? Are you happy for your organisation's logo to be displayed amongst our list of members? Would your organisation potentially be willing to take part in case studies or mini interviews about being a member of the Alliance for publicity purposes?