Group Update Form (please provide as much information as possible)

Today's date

-- mm/dd/yy

Group Code (leave blank if you do not know)

Group Name

Date Group was formed

-- mm/dd/yy

Area

Region

Previous Group Contact Person (Group Mailing Address)

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

New Group Contact Person (if different from above)

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

This group holds how many meetings per week?

Which day(s) does the group hold meeting(s)? ( check all that apply)

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

What is the meeting time(s)? (if multiple days, enter either M,TU,W,TH,F,S,SU after the time, separated by a comma. Ex. 8pm-M, 7pm-W, etc.)

Meeting Language

English
Espanola
Other

Meeting Format (check all that apply)

Open Discussion
Closed Discussion
Topic Discussion
Panel Discussion
Meditation Study
Basic Text Study
Step Study
Tradition Study
Step Working Guide Study
Concept Study
It Works How and Why Study
Speaker
Candlelight

Is the meeting wheelchair accessible?

Yes No

Is the meeting closed for addicts only or open?

Open
Closed

Old Meeting Location

Meeting Place
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

New Meeting Location

Meeting place
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

If this meeting is held in a correctional or treatment facility, what is the special criteria for entry?