Request Form for Shared Virtual Account – New and Renewal

Is this a first time request for a Shared Virtual Account time-slot (on Zoom) , a renewal for next year, or update of group contact information??First time requestRenewal for next year (due Dec 1st for the next year)Update of contact or other group Information

What type of meeting is this? *MA Group Meeting (listed on website mtg list)Other MA Meeting ( e.g. District, Committee, etc…)

Name *

Email Address *

What is the role in your Area 25 group? *GRCMADesignated by group to be shared Zoom account contact

Name and email address of CMA or GR *So we have a second contact for the shared zoom account info. Please contact the Westboro Office to register a GR or CMA for your group if you don’t have one.

How is this group paying for their zoom slot? *Group donation via websiteCheck (mailed to Westborough Office)

What is the PayPal Transaction # and date?

In which town or district is this meeting registered? *

What is your meeting number? *You can find your meeting number on the MA meeting list.

What is your meeting name? *You can find your meeting name on the MA website.

What is your meeting start time?make sure to include AM or PM

What is your meeting end time?make sure to include AM or PM

Would your group like to be online or online and in-person for the foreseeable future?YesNoUndecided

Comments or questions