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General Information

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1. Name *

First

Last

3. Job Title *

4. Phone *

5. Email *

6. Company name *

Country / Region *

Method of Payment

Cost: TT$150.00 (non-members) TT$100.00 (members) *

Bank Deposit or Online Banking (Alzheimer's Association of Trinidad and Tobago RBC Royal Bank, West Mall Branch Account No. 100093110125138) Cash (Office 15 Nepaul Street, St. James (Thurs 10am - 2pm) Cheque (Payable to Alzheimer’s Association of Trinidad and Tobago)

Data Privacy Agreement

Use and Disclosure of Personal Data Information stored in the registration system will exclusively be used in relation to this event or a subsequent event. Your personal data will only be passed on to third parties if this is necessary for the organization of the event, for billing purposes or for legal reasons, but it will not be distributed or sold to other parties for other purposes. Right to Information Upon request, the organizers of this event will provide you, in writing, with all personal data they have stored about you.

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I accept the data privacy agreement.

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