Advocate Sign-up

Being a JDRF Advocate is easy and doesn’t require a lot of your time – which is the most important contribution you can make. It’s as easy as sending an e-mail, or calling or meeting with your Member of Parliament (MP) to share your personal story. As a JDRF Advocate, your personal story makes an added impact when you join forces with the thousands of other Advocates across Canada.

Advocate Sign-up Request Form

*First Name:

*Last Name:

*Address:

*City:

*Province:

*Postal Code:

*E-mail:

 I consent to receive electronic messages from JDRF Canada, including emails, text messages, social network messages, contest notifications, publications, e-newsletters, updates, announcements, events, promotions and invitations. This information will not be shared and you will always have the option to unsubscribe.

Residential Phone:

Business Phone:

Business Fax:

Do you have a connection to diabetes

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If yes, choose one of the following types of connections:

Yourself

Your child

A relative other than child

Friend

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Type 1
Type 1

Type 1

Type 1

Type 1

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Type 2

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