Nassau InterGroup of Alcoholics Anonymous
361 Hempstead Turnpike, West Hempstead, NY 11552~1342
Hot Line: (516) 292~3040 Office: (516) 292~3045
NIG Number
eMail Address: NassauInterGroup@juno.com WebSite: http://www.nassauaa.org
Ue Group Officers Form
eU
Date
GSO Number
Group Town:
Group Name:
Mtg Facility:
Mtg Addr:
Zip:
Grp Mail Addr:
Grp Mail Town:
Zip:
It is recommended that every group maintain a permanent mailing address at a local post office.
Confidential
Confidential
Please fill this form out completely and PLEASE print legibly!
Group ChairPerson
Group Secretary
Name:
Name:
Addr:
Addr:
Town:
Zip:
Town:
Zip:
Phone: (H):
(W):
Phone: (H):
(W):
Program ChairPerson
Group Treasurer
Name:
Name:
Addr:
Addr:
Town:
Zip:
Town:
Zip:
Phone: (H):
(W):
Phone: (H):
(W):
Institutions Representative
Share~a~Day Rep (Sep ~ May)
Name:
Name:
Addr:
Addr:
Town:
Zip:
Town:
Zip:
Phone: (H):
(W):
Phone: (H):
(W):
Nassau InterGroup Rep (2 year term)
InterGroup Alternate (2 year term)
Name:
Name:
Addr:
Addr:
Town:
Zip:
Town:
Zip:
Phone: (H):
(W):
Phone: (H):
(W):
General Service Rep (2 year term)
After your group elections,
meeting (the 1st Thursday-
Name:
this form must be returned to
Jan/Jul) or mail it to the office.
the InterGroup office by the
Addr:
Only groups returning this form
Jan/Jul Reps meeting. Either Town:
will receive a Secretary-Program
Zip:
have your rep return it at that Phone: (H):
Chairperson roster.
(W):
InterGroup needs your help to carry the message of AA.
Will your group handle the 12th Step Night HotLine for one week this year?
Contact Person:
Phone: _
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