New account

Before you can enrol in the U-First! Online course, please complete the form below to create your ALZeducate account.

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Username

Password

The password must have at least 6 characters, at least 1 digit(s), at least 1 lower case letter(s), at least 1 upper case letter(s)

Email address Required field

Email (again) Required field

First name Required field

Surname

Your mailing address is required to receive course materials

Street Address Required field

City/town

State/Province Required field

Postal Code Required field

Country

Dementia Care Role Required field

Health Care Provider Required field

First Responder Role Required field

Primary Field of Employment Required field

Name of Employer

Required fields in this form are marked