Community Education Programs

*To register, please select one or more events below which you plan to attend.

	Understanding Behavior in Dementia Wednesday, June 22, 2005 6:30 - 8:00 pm Arden Courts Assisted Living 7104 Braddock Road Annandale, VA 22003
	How to Have a Good Visit With Those Who Have Dementia Monday, June 27, 2005 6:30 - 8:00 pm Potomac Place 2133 Montgomery Ave. Woodbridge, VA 22191
	Maintain Your Brain Thursday, July 30, 2005 6:30 - 7:30 pm The Hermitage 5000 Fairbanks Ave. Alexandria, VA 22311
	Maintain Your Brain Thursday, August 4, 2005 10:30 am - 12:00 pm Clark Senior Center 1210 Charles Street LaPlata, MD 20646
	Understanding Behavior in Dementia Thursday, August 4, 2005 6:30 - 8:00 pm Sunrise Assisted Living at George Mason 4300 George Mason Blvd. Fairfax, VA 22030
	Understanding Behavior in Dementia Thursday, August 18, 2005 6:30 - 8:00 pm The Gables of Mount Vernon 3709 Shannons Green Way Alexandria, VA 22309

*required fields

*First Name
*Last Name
*Email address:
*Phone number:
*Street Address
*City
*State
*Zip Code

Optional Survey Information:

Age range: Please SelectUnder 30between 30 and 50over 50

Caregiver Status
(check all appropriate answers)

Are you a caregiver for someone with memory loss?
Are you concerned that someone you know may be experiencing memory loss?
Are you experiencing memory loss?

Have you attended Alzheimer's Association educational programs in the past?

Yes   No

Ethnicity

Additional Comments/Information:

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703-359-4440 or toll-free 1-800-272-3900