Alzheimer's Foundation of America

Level of Membership

	Member/Nonprofit Organization
	Associate Member/For-profit Organization

Membership Dues:

$ (input as 0.00)

Organization Information

Organization Name:	*
Address:	*
Address 2:
City:	*
State/U.S. Territory:	*
Zip:	*
Day Telephone:	- - *
Fax Number:	- -
Web Site Address:	http://
Executive Director:	*
Contact Person:	*
Email Address:	*
Federal Tax ID:
Annual Budget:	$ *

Membership Access Information

As a member/associate member of AFA, you will be able to log into a members only area to share best practices with fellow AFA member organizations, view membership specific notifications and make changes to information about your organization. You will need to log into this page to submit additional information about your organization prior to being listed on AFA’s Web site.

Create your Login ID and Password here.

Login ID:	*
Password:	*

Processing is done by www.4agoodcause.com.
You will be transferred to this site to pay for membership. Once the transaction
is completed you will be transferred back to a confirmation page.

Membership/Associate Membership Application