COVID-19 Funding Requests

If your chapter requires monetary funding or tablet donations for your remote visits with your facilities, please fill out the following form with the details of your request. We will review the request and meet with your Directors team via Google Hangouts to discuss the details and logistics of your request.

After you fill out the form below, you will be redirected to an appointment page to sign up for your meeting with a National Alzheimer’s Buddies board member. If you encounter any problems, you can also access the appointment page HERE:

Chapter

Chapter Email

College/Personal Email

Please provide another email address we can use to reach you.

Have you discussed the logistics of your remote visits with your facility?

Please indicate whether you are requesting support in the form of tablets or funding.

Tablets

Funding

How many tablets and/or how much funding are you requesting?

Use of funding/tablets

Please describe how your chapter plans to use your requested funds and/or tablets and which facility you will be having remote visits with.