Become a Member

By becoming a member of alza you are directly supporting the association's specialised responses for people with dementia and their families in the Autonomous Region of the Azores.

Anyone over 18 years of age can become a member.

Fill in the registration form below. After submission, we will contact you to confirm your membership.

* Required fields

Member Details

Full Name *

Occupation

Date of Birth

Sex

F M

Address *

Postal Code *

Municipality *

Parish *

ID / Citizen Card No. *

Tax Number (NIF) *

E-mail *

Phone *

Phone

Membership Fee Payment

The Association's annual membership fee of 20€ should be paid by bank transfer to the IBAN below, at Caixa Geral de Depósitos.

IBAN · Caixa Geral de Depósitos

PT50 0035 0627 0007 4021 8303 8

The corresponding receipt will be issued after the proof of payment is sent to the e-mail address alzheimer.acores@alza.pt.

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Become a Member

Member Details

Membership Fee Payment