Dementia Researcher Communities App Enquiry Form

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Dementia Researcher Communities App Enquiry Form

Complete this form if you are a community / group leader who would like to enquire about having your own group within the Dementia Researcher Communities App - for futher informationor questions email dementiaresearcher@ucl.ac.uk

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* Indicates required question

Your Name *

Your answer

Your Institution *

Your answer

Your Email *

Your answer

Proposed Group Name *

Your answer

Purpose of the Group *

Your answer

Expected Membership Numbers *

Your answer

Group Type *

Open

Closed

Private

Not Sure

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