There are 3 options to choose from….
Click here for PDF form or Word Document form (DOWNLOAD AND PRINT OUT)
OR
File out the ON-LINE form below ( “PRINT” CAPABILITY AVAILABLE AT THE BOTTOM OF FORM)
[captainform i743032]
If the Group is to be listed in the Directory, please provide a telephone number and mailing address for the GSR, Alternate GSR or Group contact. Listing in the Directory is for Twelfth Step referral and/or for meeting information. The GSR’s (or other contact) name and telephone number will be included in the Directory with the group’s name and service number.