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LOPF and Age Friendly Dementia Friendly Logos

Sign up to be Age and Dementia Friendly

Contact 2

The purpose of this form is to collect the information we need to process your application as an Age and Dementia Friendly organisation.

If you're having any problems completing this form, please contact Sarah Prescott sarah@opforum.org.uk (Mon/Tues only) or Jenni Scott jenni@opforum.org.uk

This is the name that will appear on the online list of organisations that have signed up
Brief summary (eg 'We are a cafe' or 'We are a petrol station'). Please tell us if you already do things specifically with or for older people.
Please tick any areas that your organisation is active
Age and Dementia Friendly Business

What is your organisation going to do to be more Age Friendly?

Please be specific and ensure any actions are measurable and achievable over the next 12 months. Here are some examples of things you might do:

  • Join the Come in and Rest Scheme and offer a seat to an older person who needs it
  • Identify an Age Friendly Ambassador within your staff team
  • Ensure your printed materials are in large clear fonts
What Age Friendly actions are you going to take?

What is your organisation going to do to be more Dementia Friendly?

Please be specific and ensure any actions are measurable and achievable over the next 12 months. Here are some examples of things you might do:

  • Offer a Dementia Friends session for your staff
  • Ensure signs are fixed to the doors they refer to, not adjacent to them
  • Signpost customers to places where they can get dementia support
What Dementia Friendly actions are you going to take?
Contact 1

Your contact details

We'll use your address to send out your stickers and on our online map of Age and Dementia Friendly locations. If you do not have a public venue, or you have more than one venue you would like adding to the map, please email sarah@opforum.org.uk with the details.

We will use this email address to contact your organisation.
Activity

The Friendly Communities team will send a monthly newsletter and occasional relevant information to the main contact email.

We will use the contact information you provide to contact you again regarding your Age and Dementia friendly status and to ask for feedback to monitor and evaluate the programme.

Leeds Directory

Organisations that are signed up can also be listed on Leeds Directory as Age and Dementia Friendly places. This is a Leeds City Council online source of information about a range of local community care, support services and activities.

Would you like to be contacted by Leeds Directory about a free listing in the directory or to have the Age and Dementia Friendly logos added to your current listing?
Come and Rest

Stickers

Window stickers are available! We will provide one Age Friendly and one Dementia Friendly window sticker per venue. If you have more than one venue or several public entrances to your venue then please contact sarah@opforum.org.uk to request additional window stickers.

Join Come in and Rest

If you would also like to join Come In and Rest please tell us here. We will provide one Come in and Rest window sticker per venue. If you have more than one venue or several public entrances to your venue then please contact sarah@opforum.org.uk to request additional window stickers.

We'll include your contact address on our online map of 'Come in and Rest' locations. If you would like to use a different address please fill it in below.

Join Come and Rest
Venue

Come In and Rest Venue

Thank you for completing this form and choosing to be Age and Dementia Friendly.

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