Name

First Name Please Last Name Initial Only Needed

First Name

Last Name

Phone

(###)

###

####

Your personal email This email address does not need to be used for the position. We will provide an email address for you to check and use.

Subject

What service position were you thinking about? GSR, Intergroup Rep, Just Communication Liaison

Message

Please let us know which meeting group you would like to support We need the following: Meeting location Meeting Day Meeting time Group Name