NS Re-register form

GROUP MEETING CONFIRMATION (One Time Only) - Please provide the following:

Name of meeting (or none): (*)

Day(s) of Week and time (hr:min am or pm) - list if more than one: (*)

Full name of facility: (*)

Facility street address: (*)

City name and Zip: (*)

Other directions (use rear door, etc.):

Meeting type - select one: (*)

Meeting format - select one: (*)

Meeting info - other, if needed:

If applicable - Handicapped accessible

If appicable - Child Care Available

If applicable - Smoking Permitted

Name of Group Secretary: (*)

Phone number for Group Secretary (*)

Email address of Group Secretary (or designee): (*)

Welcome Home >
NS Re-register form >

Mansfield Area InterGroup

of Alcoholics Anonymous, Mansfield, Ohio