Al-Anon Electronic Meeting: Group Registration Form

Please read the guidelines carefully before filling up the form.

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