Intergroup Rep Name *

Group Name, Location, Time *

Email *

General Chair – Select One *

or Write In Different Name *

Vice Chair – Select One *

or Write In Different Name *

Select One *

Treasurer – Select One *

or Write In Different Name *

Recording Secretary – Select One *

or Write In Different Name *

Corresponding Secretary – Select One *

or Write In Different Name *

Literature Committee Chair – Select One *

Select One *

or Write In Different Name *

Retreat Committee Chairs (2 people) – Choose Any 2 *

or Write In Different Name *

Inspiration Line Coordinator – Select One *

or Write In Different Name *

Information Line Coordinator -Select One *

or Write In Different Name *

Headline News Editor – Select One *

or Write In Different Name *

Web Site Coordinator – Select One *

or Write In Different Name *

Meeting List Coordinator – Select One *

or Write In Different Name *

Social Committee Coordinator – Select One *

or Write In Different Name *

Institutions & Outreach Committee Coordinator – Select One *

or Write In Different Name *

ABM Delegates (2 people) – Choose 2 *

or Write In Different Name *