Please ensure that only one person per organization completes this form.
"LEAD CONTACT" refers to the person (e.g. Executive Director, Administrator, General Manager, etc.) who will be coordinating registration and communicating information about the program and signing the licensing agreement. This person may or may not be attending the workshop.
"PARTICIPANT" refers to the person who will be attending the workshop. Participants will become certified Facilitators of the LIVING the Dementia Journey program. Ideally, participants should be passionate about dementia and be able to draw and share stories from real-life experiences of working or living with someone with a diagnosis of dementia.
Note: Only complete applications will be accepted.