Assembly Registration 2025 Spring Assembly Registration "*" indicates required fields Name* First Last Phone*Email* Group #*Name of Group*District #*Group's Meeting Location (City)*To search for the group # go to: https://al-anon-az.org/membership/member-group-records-corner/Are You Voting for a Group* Yes No Is this your First Assemby?* Yes No How Will You Be Attending?* In Person Zoom Please Select Your Attendance Position(Check all that apply) Hold down “Control” button to select multiple options on PC/Mac.DRCoordinatorLiaisonOfficerInterested MemberGRPast DelegateOtherPlease State Other Position*Special Lunch Need?If needed, check one or both Vegetarian Gluten Free Spanish Interpretation Requested Yes No Mail-In Payment Date (Treasurer Only)* MM slash DD slash YYYY Amount Paid (Treasurer Only)*Payment*Al-Anon Registration (GR, DR, Liaison, Interested Member)Alateen RegistrationWould you like to make a 7th tradition contribution? Yes How much would you like to donate? Total Payment Method*Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged. Δ
