Fillable Form F-28 - Alcoholics Anonymous Group Information Change printable pdf download

LCOHOLICS

NONYMOUS

ROUP

NFORMATION

HANGE

ORM

U.S. and Canada

GROUP SERVICE No. ________________________________

DATE: ____________________

DELEGATE AREA No. _______________ DISTRICT No. _____________ No. OF MEMBERS: _______________

OLD INFORMATION

NEW INFORMATION

GROUP NAME:

________________________________________________

Group Meeting Location: _________________________________

Street: __________________________________________________

City/Town: _____________________________________________

State/Province: __________________________________________

Zip Code: ____________ Telephone: _____________________

MEETING DAY

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MON

TUES

WED

THUR

FRI

SAT

SUN

MON

TUES

WED

THUR

FRI

SAT

SUN

MEETING TIMES

_________

GENERAL SERVICE REPRESENTATIVE (G.S.R.)

Name: ________________________________________________

Street: ________________________________________________

City/Town: ______________________________________________

State/Province: __________________________________________

Zip Code: ____________ Telephone : ______________________

E-mail: ________________________________________________

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ALTERNATE G.S.R.

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or MAIL CONTACT

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ALTERNATE G.S.R.

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or MAIL CONTACT

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(Please check one

)

(Please check one

)

Name: ________________________________________________

Street: ________________________________________________

City/Town: ______________________________________________

State/Province: __________________________________________

Zip Code: ____________ Telephone : ______________________

E-mail: ________________________________________________

If the Group is to be listed in the Directory, please provide a telephone number and mailing address for the G.S.R., Alternate

G.S.R., or Group contact. Listing in the Directory is for Twelfth Step referral and/or for meeting information. The G.S.R.’s (or other

contact) name and telephone number will be included in the Directory with the group’s name and service number.

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OK TO LIST IN THE DIRECTORY?

Yes

SIGN TURE: _________________________________________________________________

DATE: ______________________

“Our membership ought to include all who suffer from alcoholism. Hence we may refuse none who wish to recover. Nor ought A.A. Membership ever depend

upon money or conformity. Any two or three alcoholics gathered together for sobriety may call themselves an A.A. group, provided that, as a group they have

no other affiliation.” — Tradition Three (the long form)

“Each Alcoholics Anonymous group ought to be a spiritual entity having but one primary purpose — that of carrying its message to the alcoholic who still suffers.”

— Tradition Five (the long form)

“Unless there is approximate conformity to A.A.’s Twelve Traditions, the group... can deteriorate and die.” — Twelve Steps and Twelve Traditions, page 174.

THREE WAYS TO RETURN THIS FORM:

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Postal Mail to: A.A. World Services, Inc.

By Fax: 212-870-3003 (Attn: Records)

E-mail:

Grand Central Station

P.O. Box 459

New York, NY 10163

F-28 - Revised 7-09