| A | B | C | D | E | F | G | H | I | J | |
|---|---|---|---|---|---|---|---|---|---|---|
1 | PLEASE WRITE ALL INFORMATION LEGIBLY | Date: | Group Contact: | Phone: | ||||||
2 | Please return to Hotline Chair by email, fax or postal mail ( in that order of preference ) | |||||||||
3 | Email : | phones@suffolkny-aa.org | AVAIL CODES | |||||||
4 | Fax : | 631-654-1110 | A | = Anytime | ||||||
5 | Mail : | Suffolk Intergroup Association | W | = Weekends | ||||||
6 | P.O. Box 659 - Patchogue, NY 11772 | E | = Evenings | |||||||
7 | Name of Group : | N | = Nights | |||||||
8 | Meeting Place ( Address ) : | D | = Days | |||||||
9 | Meetings (Day, Time, Type) : | S | = Summers Only | |||||||
10 | Volunteers Must Have One Year Sobriety | |||||||||
11 | M/F or Other | First Name, Last Initial | Locality (Town you live in) | Phone No | Avail | |||||
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32 | PLEASE COMPLETE ALL INFORMATION LEGIBLY | |||||||||
33 | Please list only ONE Town and use only the letters on “Avail Code” | |||||||||