community agency dedicated to improving the quality of life for persons with Alzheimer Disease   

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To setup your own Electric Hat Random Name Chooser fill in the following information. Your email address is used as the contact address for the participants in your group and your name is used to generate the settings. None of the information in this form will be used for any other purpose.

Once you submit the form you will be sent an email message with your username, password and the address to the Random Name Chooser administration section. When you logon you will have access to your administration panel. You can then entered the names of the people who will be participating in your draw. Once the draw is ready, send the participants a note with the address of the Random Name Chooser so they can pick their match.

The standard, free version provides 90 days of service.

If you would like to extend that to one year or take advantage of other features you can upgrade your account to the premium version at any time for $5 through Paypal. The premium version provides the ability to modify your email address, group name and passwords. It has a 'spouse' options so that couples do not pick each other. You can also upload or link to your own image (image dimensions are 150 pixels maximum, based on height or width). The premium version also provides technical support for the program.

Please review the Terms and Conditions before proceeding.

Fill in the following information:

Email: 


Admin Password: 


Group Name: 


Group Password: 


Please choose an image:
(Premium users can change to their own image after registration)


Reindeer


Budgie


Sphere



Pup


Pot-o-gold


Tulips



Triangle


Evening


No Image


Standard version:       Premium version:

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