Group Registration /
Records Change Form

This is an on-line form to submit in your group records changes or register a new meeting with SCWS and the World Service Office (WSO). If you submit the information to SCWS, we will forward your information to WSO.

You can print out a form and mail it in by clicking here if you would rather not submit the informaiton on-line.

This form is a little confusing, so you might want to download and read the "How to fill out the Al-Anon Registration/Group Records Change Form" instructions.

Your email address should have any questions (required):
(1) Meeting ID
WSO ID Number    District Number    -  AREA # 04
(2) Registration Status
New  Current  Not Sure If Registered  Disbanded
(3) Group Type (Check all that apply)
Beginners  Al-Anon Adult Children  Limited Access  Institution  Other (e.g., Men, Women, Step-Study, Parent, Gay)
(4) Changes (Check all that apply)
Mailing Address  Group Name  Meeting Place  Meeting Time  Meeting Day    Group Rep  Alt. Group Rep  Contact  Other
(5) Special Needs & Group Features
Open   Closed   Babysitting   Signing (ASL)  Handicap Access  Non-Smoking  Language Spoken  Mailing Language  Special Instructions
(6) Current Mailing Address
	Group Rep  Alternate Group Rep
Name
Street/PO Box
City, Zip
Phone	E-Mail
(7-11) Meeting Information
Group Name
Meeting Place
Street/PO Box
City, Zip
No. of Members	Meeting Day  Select Sunday Monday Tuesday Wednesday Thursday Friday Saturday  Time   AM  PM
(12) Contacts (WSO refers newcomers and visitors to these members for information.)
First Name	Phone #
First Name	Phone #
(13) Additional Meeting Contact (Optional)
Name
Street/PO Box
City, Zip
Phone	E-Mail
(14) District Officers / Intergroup Liasons / Convention Chairs
Title	Please Select District Rep Alternate District Rep District Liason / Coordinator Intergroup Liaison Convention Chair
Name
Street/PO Box
City, Zip
Phone	E-Mail