Meeting Change Info and Annual Update Form – draft

Meeting registration WSO ID# *ID# is on MA Website Meeting List

Meeting Day, Time, Town listed on MA Website *

CMA Information (group contact)Information is kept confidential

CMA Name (group contact)

CMA Email Address

CMA Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

GR informationCan write “No GR” or “GR same as CMA” in GR Name field

GR Nameor type “NO Current GR” or “GR same as CMA”

GR Phone

GR Email Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Meeting Name *E.g., One Day at a Time has become Keep it Simple

Meeting Town *For a District 25 meeting enter “Monroe”

Request district change *Note: District change needs to be approved by outgoing and incoming districts

Meeting Start Time *Make sure to include AM or PM

Meeting End Time *Make sure to include AM or PM

About how many attend this meeting?

How is your group meeting? *IN-PersonVirtual (video like Zoom and/or dial-in)Both In-Person and Virtual

Location of meeting *

Address of meeting *

Is there wheelchair access? *YesNo

Special in-person instructionsE.G., Masks required, limited number, meeting outside bring chair, meeting in an alternative location,…

What is the virtual meeting password?or write “no password”

What is the virtual meeting I.D.E.g., Zoom or Conference call ID or you can add an email contact to get meeting access. Please, no emails containing first and last names please.

What is the link to the meeting?You can also write “none”

What is the dial-in number?

Is your group interested in joining the MA Shared Virtual Zoom Account?YesNoWe already have a slot

Who is submitting this form?

Name

Phone

Role of Person Submitting FormGRCMADRDesignated by group to make change

Email Address

Any comments or questions?if you group is meeting more than 1 day a week, enter the other days and times here.