New Group & Group Information Update Form New Group & Group Information Update Form Date:* MM slash DD slash YYYY District:*District 1District 2District 5District 14District 17District 18District 20Group Name:* Group Service Number: (if known) Meeting Type: (Multi-Select Meeting Type if Needed)11th Step Meditation12 Steps & 12 TraditionsAs Bill Sees ItBabysitting AvailableBig BookBirthdayBreakfastCandlelightChild-FriendlyClosedConcurrent with Al-AnonConcurrent with AlateenCross Talk PermittedDaily ReflectionsDigital BasketDiscussionDual DiagnosisEnglishFragrance FreeFrenchGayGrapevineHebrewIndigenousItalianJapaneseKoreanLesbianLiteratureLiving SoberLGBTQMeditationMenNative AmericanNewcomerNon-BinaryOpenOnline MeetingPeople of ColorPolishPortugueseProfessionalsPunjabiRussianSecularSign LanguageSmoking PermittedSpanishSpeakerStep MeetingTemporarily SuspendedTradition StudyTransgenderWheelchair AccessWheelchair-Accessible BathroomWomenYoung People# of Members: Check if New Group:* Yes No Date Group Started: MM slash DD slash YYYY Meeting Location: Meeting City* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Meeting Days: (Multi-Select Days if Needed)*MondayTuesdayWednesdayThursdayFridaySaturdaySundayBeginning Meeting Time:* : Hours Minutes AM PM AM/PM Ending Meeting Time:* : Hours Minutes AM PM AM/PM Online Meeting:* Yes No Type of Online Meeting:ZoomGoToMeetingFreeConferenceCall.comConference CallURL: Meeting ID: Access Code: (if needed) Phone Number:Group Contact Information* New GSR: New DCM: New Group Contact Full Name:* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email:* Do You Want to Receive Hi Country News, via email? Yes No List Name and Phone # in GSO Directory? Yes No New Alt. GSR: New Alt. DCM Additional Group Contact Full Name: Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email: Do You Want to Receive Hi Country News, via email? Yes No List Name and Phone # in GSO Directory? Yes No PhoneThis field is for validation purposes and should be left unchanged. Δ
