Discovering Dementia | Mailing List

Darganfod Dementia Sir y Fflint / Discovering Dementia

Nodyn: rhaid llenwi pob maes sydd âseren goch (*) / Please note: all fields with a red asterisk must be completed

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Enw / Name*

Enw Cyntaf/ First NameCyfenw / Last Name
Cyfeiriad / Address

Cyfeiriad Stryd / Street Address

Cyfeiriad Stryd Llinell 2 / Street Address Line 2

Tre/ TownSir / County

Cod Post / Post CodeCountry
E-bost / Email*
example@example.com
Hoffwn gael fy ychwanegu at RestrBostio Darganfod Dementia / I would like to be added to the Mailing List

Ie / YesNa / No
Rhif Ffôn / Phone Number
Rhowch rif ffôn dilys. / Please enter a valid phone number.
Rwy’n berson sy’n byw gyda dementia— hoffwn sgwrsio mwy am yr hyn syddar gael. / I'm a person living with dementia - I'd like to chat more about what's available

Ie / YesNa / No
Rwy’n aelod o deulu rhywun sy’n bywgyda dementia — hoffwn sgwrsio mwyam yr hyn sydd ar gael. / I'm the family member of someone living with dementia - I'd like to chat more about what's available

YesNo
Rwy’n weithiwr proffesiynol sy’n gweithio gyda phobl sy’n byw gyda dementia — hoffwn sgwrsio mwy am yr hyn sydd ar gael. / I'm a professional working with people living with dementia - I'd like to chat more about what's available

Ie / YesNa / No
Hoffwn gael rhagor o wybodaeth am gymunedau sy’n gyfeillgar i bobl â dementia. / I would like more information on dementia friendly communities

Ie / YesNa / No
Hoffwn gael hyfforddiant ar ddementia (i mi fy hunan neu ar gyfer grŵp). / I would like training on dementia (personally or for a group)

Ie / YesNa / No
Hoffwn gael rhagor o wybodaeth am wasanaeth cludiant Darganfod Dementia. / I'd like more information about the Discovering Dementia transport service

Ie / YesNa / No
Rwy’n rhedeg grŵp sy’n croesawu pobl sy’n byw gyda dementia, a hoffwn ddweud mwy wrthych chi amdano. / I run a group which welcomes people living with dementia and I'd like to tell you more about it

Ie / YesNa / No
A ydych chi’n dod o sefydliad neu fusnes? Os felly, rhowch ei enw. / Are you from an organisation or business? If so please name it
Unrhyw beth arall? Mae croeso i chi gyflwyno unrhyw gwestiynau sydd gennych i ni yma! / Anything else? Feel free to pop any questions you have for us here!
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Darganfod Dementia Sir y Fflint / Discovering Dementia