Name *

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Address *

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To enable us to provide you with information relating to how you would like to be involved with ‘ADS’ please choose any of the following that apply or let us know any other area you might like to be involved in. *

Volunteering: General

Volunteering: Shop

Volunteering: Fundraising / Tin Collection

Befriending a Person with Dementia

‘ADS’ Dementia Training

Other (please mention below)

How would you like us to get back in contact to discuss working with ‘ADS’ ? *

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I would like to receive by email: *

'ADS' Information and Monthly Newsletter

No information

I agree with the following: *

All ‘ADS’ Volunteers are required to have a DBS check which we will organise FOC. Please tick to advise that you are aware of this and would be happy to be DBS checked.

Please tick that by submitting this form, you are giving ‘ADS’ full photo-use consent and agreeing to the terms of our Privacy Notice.