Area 51 New Group Form Please enable JavaScript in your browser to complete this form.About an AA Group“Our membership ought to include all who suffer from alcoholism. Hence we may refuse none who wish to recover. Nor ought A.A. Membership ever depend upon money or conformity. Any two or three alcoholics gathered together for sobriety may call themselves an A.A. group, provided that, as a group they have no other affiliation.” — Tradition Three (the long form)“Each Alcoholics Anonymous group ought to be a spiritual entity having but one primary purpose — that of carrying its message to the alcoholic who still suffers.” — Tradition Five (the long form)“Unless there is approximate conformity to A.A.’s Twelve Traditions, the group… can deteriorate and die.” — Twelve Steps and Twelve Traditions, page 174.A.A.’s Traditions suggest that a group not be named after a facility or person (living or deceased), and that the name of a group not imply affiliation with any sect, religion, organization or institution.Information for person submitting this form.Name *FirstLastEmail *PhoneGroup InofrmationGroup Name *What are you going to call yourselves?Group Start Date *Group Meeting Location *What is the building called you meet in?Number of MembersEstimate Average AttendanceGroup TypeMen, Women, Book Study, etc..Group Meeting Location AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow many days a week does your group meet? *1234567What day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursWhat day of the week? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat Time of Day? *How long is your meeting? *1 Hour1 1/2 Hours2 HoursSend correspondence from G.S.O. in what Language?English, Spanish, etc…General Service RepresentativeGSR Name *FirstLastGSR Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeGSR Email Address *GSR Phone Number *How should the GSR receive their kit? *Printed KitDigital KitOpt OutAlternate GSR or Mail ContactAlternate GSRMail Contact if different from GSRDoes your Group meet in a hospital, treatment center or detox center? *NoYesIf yes, is it open to A.A. members in the community as well as to patients in the center? *NoYesG.S.O. publishes confidential A.A. Directories for use by A.A. members for Twelfth Step referral and/or meeting information. The Directories include a group’s name and service number, and the full names and phone numbers of the contacts listed on this form. Do you want your group listed in the Directory covering your region? *YesNoSee comment belowG.S.O. maintains its own meeting directory list that groups can opt out of, it is located here.District Number *What district is your group in?SignatureBy submitting your name in this field it acts the same as a signature.For Area 51 Records Keeper OnlyGSNGroup Service Number Assigned by G.S.O. when your group registered.Name *FirstLastCommentSubmit