Alateen Group Registration / Records Change Form Alateen Group Registration / Records Change Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Submitted by (Should we have any questions) Phone ID Name Name *Phone Number *Email Address *WSO ID NumberIf you don't know the WSO ID number, learn how to find it.District NumberIf you don't know the District number, check the District Meetings page.StatusNewChangeInactive / DisbandedNot Sure if RegisteredChangesCurrent Mailing Address (CMA)Group NameGroup Sponsors (AMIAS)Group Service PositionsMeeting DayMeeting LanguageMeeting Phone ContactMeeting PlaceMeeting TimePhone Contact Meeting Details Group NameMember CountMailing LanguageSpoken LanguageAge RangeDay—Please choose an option—SundayMondayTuesdayWednesdayThursdayFridaySaturdayTimeMeeting Place Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLocation Instructions (Enter specific information for newcomers to find the meeting, if needed)See in the Policy Digest the section titled Membership and Group Meetings/Conventions of the Al-Anon/Alateen Service Manual (P24/27) for information and definitions. Group Sponsor / AMIAS Add or Remove Group Sponsor(s). Please list the two primary group Sponsors. The WSO ID# will be assigned if new AMIAS. If CMA for the group is being removed, a replacement must be provided in order to process. Add/Remove AMIAS-Choose an Option-AddRemoveNameFirstLastWSO ID NumberPhone NumberTypeHomeWorkCellOK to list as a contactAdd/Remove AMIAS- Please choose an option -AddRemoveNameFirstLastWSO ID NumberPhone NumberTypeHomeWorkCellOK to list as a contactAdd/Remove AMIAS- Please choose an option -AddRemoveNameFirstLastPhone NumberWSO ID NumberTypeHomeWorkCellOK to list as a contact Phone Contact (if other than Sponsor). Contacts must be Al-Anon Members Involved in Alateen Service (AMIAS) First NameWSO ID NumberPhone NumberCurrent Mailing Address (CMA) All postal/electronic communications to the group are sent to the CMA; please be sure it’s a current AMIAS. Name *FirstLastAddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone NumberEmail *Group Service Positions Group Representative NameFirstLastCheck this box if the position is now vacant because of this change.VacantAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmail Alternate Group Representative NameFirstLastCheck this box if the position is now vacant because of this change.VacantAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmailCommentsSubmit
