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) Name *Phone Number *Email Address * AMIAS Email Place 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
