Start an AFA Teens Chapter | Alzheimer's Foundation of America

Thanks for your interest in starting an AFA Teens chapter at your high school/teens centric organization! Please fill out the form below to submit your request. If you have any questions, please contact AFA’s Young Leadership Coordinator, Adam Cruz at 866-232-8484, ext. 122.

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Name*

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Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Name of school that you are attending*

What grade are you in?*

School mailing address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What is your anticipated graduation year?*

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What is your major?*

Which is the best way to reach you?*

Phone

Tell us why you would like to lead an AFA Teens Chapter*

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