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P.O.W.E.R. Registration Form (In-Person Session)
Orientation: January 10, 2022 (Information collected here will be used to crate the attendance roster)
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Email
*
Your email
STOP! Before you go any further.... download and READ the P.O.W.E.R. Contract of Accountability before continuing.
http://tammyt.com/POWER/documents/contract.pdf
*
I have read and understand the Contract of Accountability
Required
P.O.W.E.R. Sponsors must have successfully completed a P.O.W.E.R. session previously with no relapse between then and now. All others are P.O.W.E.R. sponsees. Will you be attending P.O.W.E.R. as a:
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Sponsee
Sponsor
First Name
*
Your answer
Last Name
*
Your answer
Street Address (So we can mail documents as needed)
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Re-enter Email
*
Your answer
Phone Number
*
Your answer
Do you have a P.O.W.E.R. Sponsor?
*
No, I do not have a P.O.W.E.R. Sponsor
Yes
Enter your P.O.W.E.R. Sponsor's Name if you know it
Your answer
Please let us know which 12-Step program you are working the steps for (AA, MA, NA, GA, OA, Al-Anon, etc.)
Your answer
A copy of your responses will be emailed to the address you provided.
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