New meeting or change to existing meeting request form.

Request Type (Area 23)

Meeting Type/Format

Meeting Type/Format

Language

Is this an Open or Closed Meeting?

AA Group Name

Meeting Location Name (Facility/Church/Building)

Meeting Address

Address Line 1

Address Line 2

City

State

Zip Code

Meeting Days/Times (include format and any notes)

Type/Format (include Contact

Group Contact Name

First

Last

Group Contact Phone

Group Contact Email

What are you registering or changing for this AA group in Area 23? (details of new group registration or group info change)

Existing Group ID or Listing Reference (if submitting changes)

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