Group Participation Form

If your AA Group wishes to participate and receive 12th Step calls please enter the details here or download the printable form available at the bottom of this page.

Group Information

Group name: *

AA Group name

Location: *

Suburb or town where your group meets

Surrounding Suburbs:

List nearby suburbs where the group is able to do 12th Step calls

Contact Information

Group 12th Step co-ordinator

This is the person from the group who will receive the information about 12th Step calls. It could be the GSR or someone else.

Name: *

This information will be shared with all the phone call volunteers and other AA service volunteers.

Phone number: *

Email address:

Preferred contact method : *

Phone

SMS

How you would like information about 12th Step calls sent.

Other group contact

(Could be Secretary or Alternate GSR)

Name:

Only used if we are unable to contact the 12th Step co-ordinator. It will not be shared with other volunteers.

Phone number:

Public Contacts (optional)

Information that can be given to members of the public to enable them contact the group directly.

Public Group Phone Number(s): :

Group website:

AA in Melbourne Phone Roster

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