Register of interest form, Groups and Clubs

Thank you for considering fundraising for Alzheimer’s Society with your group or club!

We just need a few details about you so that we can get in touch and support you in your fundraising journey.

Contact details

To help process your enquiry, please include your contact details.

To find out more about how we use your personal information, please read our supporter privacy statement.

Title (required)

First name (required)

Surname (required)

Email address (required)

To organize your own event, you must be aged 16 or over. If you're under 16 and want to support Alzheimer's Society, you can organise a fundraiser with a responsible adult. They can request a fundraising kit and pay in donations on your behalf.

Date of birth (required)

We'll use your phone number and email address to keep you up to contact you about fundraising with us.

Phone number (required)

Address (required)

If preferred, enter or amend your address below.

Address line 1 (required)

Address line 2 (required)

Town or city (required)

County (required)

Postcode (required)

What is the name of your group or club you are affiliated with? (required)

What has inspired you to fundraise with Alzheimer’s Society? (required)

Keeping you updated

We'd also love to talk to you about the amazing work we do with our services and research, and how you can do more to help with fundraising, campaigning, or volunteering in the future.

You can update this at any time and we'll never sell your details to third parties. If we can't reach out to you for help when we need it most, our work can't continue - so please, choose to stay in touch using the boxes below and help us beat dementia.

I'd like to receive information and updates by email (required)

I'd like to hear from you via SMS (required)

I'd be happy to speak to someone on the phone (required)

Please do not contact me (required)

By submitting this form you're agreeing to our terms and conditions.

Register of interest form, Groups and Clubs

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