AL-ANON/ALATEEN GROUP REGISTRATION/UPDATE FORM

Al-Anon Family Groups Office of Southern California, Inc. (Al-Anon Central Office of L.A. County)

Groups are registered at their own request with the understanding that they will abide by the Al-Anon 12 Traditions and Principles, have no outside affiliation, and that any Al-Anon member will be welcomed to participate even though their meeting may be oriented towards a specific population.

ATTENTION SECRETARIES: Please notify this office of ALL CHANGES as they occur.

Please fill out this form and hit SUBMIT at the bottom of this form or Print this form and send to: Al-Anon Family Groups, Inc. 4936 Lankershim Blvd. North Hollywood, CA 91601 Phone: (818) 760-7122 Fax: (818) 760-7440

REGISTERING INFORMATION:

1.

(The City your meeting takes place in)

2. Day:

Sunday Monday Tuesday Wednesday Thursday Friday Saturday (choose one)

Time:

AM PM

3. Location:

4. Location Address:

5. Location City & ZIP:

6. Our meeting is an (a) 7. Our meeting is an (a)

Existing New Open Closed

, ,

Al-Anon Alateen Pre-Teen meeting. General Literature Study Step Study Tradition Study Men's Stag Women's Stag Other meeting.

	(If you chose "Other" please describe your Meeting below)

8. Our meeting has a

General Adult Child Parent Gay

focus.

9. Our meeting provides:

Examples:

Bilingual (enter Language also) Childcare Handycapped Access Beginner's Meeting (enter the time also) Younger Members Welcome

10. Secretary or Alateen Sponsor: Address: Phone:

(First and Last name) (Street Address) (City, State & Zip Code) (Include Area Code)

11. Treasurer or Alateen        Co-Sponsor: Address: Phone:

(First and Last name) (Street Address) (City, State & Zip Code) (Include Area Code)

12. Intergroup Representative: Address: Date Term Began Phone:

(First and Last name) (Street Address) (City, State & Zip Code) (Include Area Code)

13. Alternate Intergroup Rep.: Address: Phone:

(First and Last name) (Street Address) (City, State & Zip Code) (Include Area Code)

	We need a few people from each meeting who are willing to  have their first name and phone number listed with Central Office. Newcomers often need to talk to someone before going to a meeting or may need directions  or a ride to a meeting. Thankyou

	(First Name Only) Telephone Number (Include Area Code) 12 Step Contact #1: 12 Step Contact #2: 12 Step Contact #3:

	To insure full registration of your  meeting and World Service Group Representative (GR) Contact World Service for a form at: (WSO) Al-Anon Family Group Headquarters, Inc. 1600 Corporate Landing Parkway Virginia Beach, VA 23454-5617 (757)  563-1600