Start An AFA Teens Chapter

Grant Request

AFA Teens will help build leadership skills as chapters set out to engage in volunteering opportunities
along with organizing fundraising and educational events related to Alzheimers care to spread awareness.

About The Teens Chapter You Wish To Start

Thanks for your interest in starting an AFA Teens chapter at your high school/teens centric organization! Please fill out the information below to submit your request. If you have any questions, please contact AFAs Young Leadership Coordinator, Adam Cruz at 866-232-8484, ext. 122.

"*" indicates required fields

* Enter the name you will give to your AFA Teens Chapter

* Tell us why you would like to lead an AFA Teens Chapter

Type of Application (can be hidden)

Information About Your School and Yourself

Please enter the name the school you are attending.

* Organization Name

Website

School Phone

* Phone

Type of Email

Email

* School Mailing Address

* Address

Street Apt/Suite/Unit/Other

* City

*State/Province

* Zip/Postal Code

About You

* First Name

Middle Name

* Last Name

Gender

Date of Birth

If you are working, enter the business or company name

If you are working, please enter your Job Title or Occupation

* Type of Email

* Email

School Phone

* Phone

Use School Address (can hide)

* Your Address

* Address

Street Apt/Suite/Unit/Other

* City

* State/Province

* Zip/Postal Code

Additional Information

Please complete the information below to process your application.

Bio UDFs (Share important information)

*AFA - What Grade Are You In?

*AFA - What is your anticipated graduation year (YYYY)

*AFA - Which is the best way to reach you?

Email

Phone

Your comments are important to us:

We will review your application and will follow-up via email to send you a link where you can submit additional information we will require.

Your request will be processed. Do you want to continue?

Grant Request

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