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Adult Children of Alcoholics
World Service Organization, Inc.

Intergroup Registration Form


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In order for the ACA WSO to be of maximum service the following information must be current, accurate and complete. All information on this form will be used for ACA service purposes only.

The WSO asks registered ACA Intergroups and meetings to verify/update their meeting records at least once a year by submitting an updated registration form. For Intergroup updates, please include as minimum the Intergroup's ACA WSO Intergroup rumber and at least one Point of Contact, including an email address; the remaining fields can be left blank once verified as unchanged since your last submission to the WSO.

Use of this on-line form requires entry of the e-mail address of at least one point of contract (usually the Intergroup Chair or selected WSO Representative). If you prefer to not provide this information to the WSO (anonymity), please use the paper Registration Form instead. Click here to download a copy of this form.

WSO Intergroup number:
(existing Intergroups only)

Intergroup Name: (optional)

Check here if Registering for the first time.
Check here if submitting an Information Update Only.
Check here if submitting an Intergroup cancellation notice.
Don't know your WSO Intergroup number? Then click here to go to the ACA Intergroup list and scroll down to your Intergroup. When you find your Intergroup, you'll find the WSO Intergroup "IG" number in parenthesis near the end of your Intergroup's name.

PUBLIC CONTACT INFORMATION: Please supply us with the following information. This will be made available to assist people in finding your Intergroup, or to allow them to ask questions they may have about meetings for your Intergroup. The WSO will provide the information in this section on the WSO web site's Intergroup listing. Do not put any information in this section that you want kept private.

Mailing Address:
Street Address/PO Box:

City:
      
State/Province:
Zip Code:
Country:
Phone Number:
Website URL:
*Intergroup EMail Address:
When does your Intergroup Meet? Monthly Quartely Other
Meeting Day:
Meeting Time:


Any additional information on attending the Intergroup meeting:

(Cross streets, Buildings, Church, etc.)

PRIMARY CONTACT INFORMATION: Please provide the full name and address of the Primary Intergroup Representative to the WSO. The information in this section will be for use only within the WSO service structure, will be kept confidential and will not be available on the public web site. Starred fields must be filled in. See note at top of form if you are unwilling to complete this section.
Each Intergroup must have at least one contact person on record with his/her own mailing address.

*First Name:
*Last Name:

Position in Intergroup:
Street Address/PO Box:

City:
      
State/Province:
Zip Code:
Country:
Phone Number:
*EMail Address:

SECONDARY CONTACT INFORMATION: In case we cannot reach the Primary Contact Person, we also ask for a Secondary Contact Person to be identified where possible. If you have a secondary point of oontact, please provide the full name and address of that person. As with the Primary Point of Contact infomation, the information in this section will be for use only within the WSO service structure, will be kept confidential and will not be available on the public web site.

First Name:
Last Name:

Position in Intergroup:
Street Address/PO Box:

City:
      
State/Province:
Zip Code:
Country:
Phone Number:
EMail Address:

In submitting this form, I certify that

  • our ACA Intergroup agrees to follow the ACA 12 Steps and 12 Traditions to the best of our ability, that
  • I am authorized to act on behalf of this ACA Intergroup in submitting this form, and that
  • all the information provided is correct to the best of my knowledge.