Alzheimer's
Foundation of America

First National Bank of Long Island – Hicksville

Email*
Name*
First Last
Organization (if applicable)
Address*
Street Address Address Line 2 City State/Province ZIP / Postal Code
What encouraged you to sign up?
- I'm a family caregiver
- I'm a dementia care professional (i.e. doctor, nurse, social worker, home health aide)
- I'm living with a dementia-related illness
- I'm interested in learning more about AFA