New Intergroup Representative Please enable JavaScript in your browser to complete this form.Name *FirstLastEnter your first name and either your last name or last initial.Email *This will only be used to send you business meeting agendas and minutes or to contact you about important Intergroup news. Phone *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCheck your position *IGR PrimaryIGR AlternateInterested in volunteering on:PicnicUnity MeetingAnniversary DinnerGratitude DinnerSpeaker ExchangeCentral OfficeWhere & WhenPlain & StraightAdhoc Committee (any topic)Standing Committee ChairpersonStanding Committee and TopicElection/Nominating CommitteeOfficer (Executive Committee) You do not have to sign up for any committee to be an Intergroup Rep. This is in addition to your IGR duties.Home Group Name *Group Number (if registered with GSO)This is the number assigned to your group by AA World Services.Group's Meeting Place and CitySobriety Date *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Enter your sobriety date in format mm/dd/yyyy.NameSubmit
