Form – Group History

Todays Date

Person filling out this form

Your email address

Current Group Addre

Group Name

Meeting Place

Current Meeting Address

Committees & 12th step work

Day and Time of Meetings

District

Group Number if one has been assigned

Number of Members in Group

Open or Closed Meeting?

Accessible to the disabled?

Does Group have a GSR? (if so is the GSR (if so, please list)

Special Meetings

Has the Group Moved

Notes