Group Information Form Group Service Number (if known) AttendIn-PersonHybridOnline Group Name* Group Start Date Number of Home Group Members District #12345678910Not Sure Meeting Day(s)* Meeting Time* Meeting Type* Open, Closed, Lead, Discussion, Wheelchair Accessible, etc Meeting Location* Name of the building or Online Meeting Address* Complete Address or Online Meeting City* If online use GSR city Meeting State* If online use GSR state Meeting Zip Code* If online use GSR zip Meeting Notes Example: Open Speaker Last Week of Month or small building behind church Online Meeting Info Meeting ID & Passcode GSR Full Name* Sobriety Date* GSR Phone* GSR Email* GSR Address* GSR City* GSR State* GSR Zip Code* Your Message* OK to list phone and email as meeting contact on website. No names will be shown on any website.YesNo OK to list in the directory?YesNo Alt GSR Full Name Alt GSR Sobriety Date Alt GSR Phone Alt GSR Email Alt GSR Address Alt GSR City Alt GSR State Alt GSR Zip Code OK to list phone and email as meeting contact on website. No names will be shown on any website.YesNo OK to list in the directory?YesNo
