Al-Anon Electronic Meeting: Group Registration Form

Please read the guidelines carefully before filling up the form.
You can fill the form below or download the PDF form to fill it offline.

Group Record

1.What audience does the group seek to attract?*
Local /RegionalAll IndiaGlobal

2. District number* (if applicable)

3.Status*
NewRegistered/UpdateNot sure

Group/Registration overview

The group name should reflect Al-Anon principles and should be inviting to all. Contact GSO for further information.

1.First meeting* (date/month/year) 2. Group name*

3. Meeting Language* (Please specify if the meeting is bi-lingual/multilingual)
EnglishHindiBengaliMarathiTeluguTamilGujaratiKannadaMalayalamAssameseOther

4. Location: Platform must be kept constant for atleast 6 months. Choose one:*
PhoneEmailChatBlogInstant Messaging (Skype, WhatsApp, etc)Web Conferencing (e.g. Zoom, WebEx, etc)Social media (e.g. Facebook, Instagram, etc)Other

Is it a special focus meeting ?*

YesNo

If you selected Yes, please select all applicable.
Grand parents of alcoholicsMenWomenAdult ChildrenLGBTQIA+Parents of alcoholicsYoung AdultsLiterature Meeting

Group e-mail ID / Phone contact for the public

Group email id* Helpline number*

Current Mailing Address (CMA)

CMA Name* CMA Address*

Meeting Details

Additional Meetings

Any Other Information

Name and signature of Group Office bearer with date