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** Use this text file to copy and paste the following information **
** into an email and send it to: meetinglist@eparna.org           **
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Group Registration / Update Form
Please complete all information (Please print clearly)

All information is required, unless otherwise noted as optional

Today's Date:

Pick One:
    New Group:
    Existing Group Update:
    Remove Group from Meeting List:

Group Name:
This group was formed (month/year) (optional):
Area Service Committee:

Group Contact Name (optional):
Group Contact Phone# or Email (optional):

Group's Meeting Information
Meets on what Day(s):   

Meeting Begin Time (specify AM/PM):
Meeting End Time (specify AM/PM):

Format:
  Week 1:
  Week 2:
  Week 3:
  Week 4:
  Week 5 :
Please fill in each weeks format using one of the following codes:
B = Beginners    BT = Basic Text    CC = Chairperson Choice
CN = Concepts    D = Discussion     IP = Informational Pamphlet
JFT = Just For Today    T = Topic   TD = Tradition
ST = Step    SD = Speaker Discussion

Wheelchair Accessible (Yes or No):
Closed Meeting:
Open Meeting:

Meeting Location
Place / Building Name:
Room Name:
Address:
City:
State: 
Zip:
County:

(NOT REQUIRED if you don't know the Lat/long leave this blank)
     Latitude: N
     Longitude: W

Special Instructions (optional: