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GROUP MEETING INFORMATION: |
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Change Type:
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New Group
Group Update/Correction
Group Closed
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Group Name: |
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Area:
(Area Service Committee) |
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Day of Week: |
Sun
Mon
Tues
Wed
Thurs
Fri
Sat |
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Start Time: |
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Location:
(Name of Bldg, Room, etc.) |
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Address:
(Number and Street) |
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City, State, Zip: |
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Special
Directions
(Rear of bldg, etc) |
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Meeting Format |
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Week Open:
(3rd week open, etc)
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Meeting Length
(1 hour 30 minutes, etc.
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| Other
Comments |
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Codes: |
W - Wheelchair accessible with restroom
facilities
I - Sign language interpreter at this meeting
H - Sign language only
S
- Spanish spoken at this meeting
P - Polish spoken at this meeting |
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Please
confirm the change you are reporting in the Message Area box below:
(New group, Meeting time change, Moved to new location, Meeting format changed, etc.)
Use the Message Area to say why the meeting information needs changing.
This will help us make your updates into the meeting directory correctly.
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Message Area
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CONTACT INFORMATION AND VERIFICATION: |
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Name: |
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E-mail: |
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Phone: |
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Indicate your relationship with this group.
Are you representing the group as GSR, RCM, or other trusted servant?
Are you reporting this change as a helpline worker or other concerned addict?
If you are not speaking for the group officially indicate how you
know this change is needed.
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Group Relationship:
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Type the characters you see in the image into the Verification Code below.
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Verification Code: |
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