CURRENT MAILING ADDRESS (CMA)WSO mail for the group is sent to the postal and email addressesCMA First NameCMA Last NameCMA Email AddressCMA Phone #CMA Street/PO BoxCMA City/TownCMA State/ProvinceCMA Zip/Postal CodeCMA CountryBest way to contactemail, text, phone, …?Is the CMA also the Group Representative (GR) for this meeting?YesNo, there is another member serving as GRNo, but we do not have a GR at this time.GROUP REPRESENTATIVE (GR) if availableMembers of Al Anon who are also members of AA do not serve as Group Representatives. “Members honor this policy out of respect for Al Anon unity and the group conscience process, in accordance with Tradition One and Tradition Two.” (see 2022-2025 Al-Anon/Alateen Service manual, page 87)GR First NameGR Last NameGR Email AddressGR Phone #GR Street/PO BoxGR City/TownGR State/ProvinceGR Zip/Postal CodeGR CountryBest way to contactemail, text, or phoneGroup NameGroup ID#:Most groups will not have an ID# unless transferring from an Area outside of MA.SPECIAL GROUP FOCUSAlthough everyone is welcome at an Al-Anon meeting, some meetings have a special focus.Does your group have a special focus? (check all that apply)No Special FocusParents of AlcoholicsAdult ChildrenWomenMenLGBTQIA+People of ColorYoung AdultsNon-English Speaking (e.g. Spanish, Portuguese, ASL)What language?OTHER GROUP DETAILS (Check all that apply)Family and Friends Only (Closed meeting)Beginners meeting offeredStep MeetingASL interpreterPlease specify any other special meeting focus.WHAT DAY(s) DOES YOUR GROUP MEET?What day(s) does your group meet? (Check all that apply)SunMonTuesWedThursFriSatWhat time does your meeting begin on SUNDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on MONDAYS?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on TUESDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on WEDNESDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on THURSDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on FRIDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMWhat time does your meeting begin on SATURDAY?HoursMinutesAMPMFor example: for a 9:30 am start, fill-in 9 in Hours, 30 in minutes, and select AMInformation to help determine which district to place your group.Currently (or in the past) can someone get information to join this meeting on the MA Website Meeting list?NoYesHow is (or was) the meeting listed on the MA Website Meeting List?Please enter Town, Day of the Week, and start timeWhat district would your group like to join?The district associated with the town where our group was listed on the MA Website (if that district is accepting PEGs).Our group would like to join an all electronic MA district.Our group has not decided.Note that some districts are not accepting Permanent Electronic Groups (PEGs).SUBMITTED BY:NameEmail AddressPhoneBest Way to ContactPhone, text, email, …Please add any comments or questionsSUBMIT FORM
