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This name will appear with your published stories. You can use an individual name (Annie B), or create a team name (4th Floor Fantasticos!)

This email address will be your username and will be the address we use to send you all correspondences.


Telling us your location makes it easier for people to find your stories.

I hope to use TimeSlips with (you can check more than one):

Myself!

One-on-one with family

One-on-one with clients

Groups of people with dementia

(For best results, we strongly encourage you to take the fun and easy Online TimeSlips training!) Order TimeSlips Training

Other

(please describe)

Tell us about who you're using TimeSlips with.

What is your age?

Under 12 years old

12-17 years old

18-24 years old

25-34 years old

35-44 years old

45-54 years old

55-64 years old

65-74 years old

75 years or older

Creativity happens at all ages!

What is your ethnic background?

White

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What is your household income?

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$20,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 to $199,999

$200,000 or more

This is optional, but it helps us secure funding and tell our story.

If you could change your name to anything what would it be?

Just for fun!

If you were an animal what would it be?

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