Alcoholics Anonymous

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Please enter your contact information This registration will replace the sign-in sheets at Assembly Required fields are red
I WILL BE ATTENDING:

Email:			Phone Number:
First Name:		Last Name:
Address:	If you would like to receive assembly minutes and documents by snail mail please enter your complete mailing address
City:			State: Zip/Postal Code:
District:	If you don't know what district you are in choose the county where your home group is located
How Many years of sobriety do you have? please enter years only (.08 = 30 days) (.16 = 60 days) (.25 = 90 days) (.5 = 6 months) (.75 = 9 months)		Home Group:
Are you a		Position:
	Have you attended an assembly before?	Yes NO