Email NameFirstLast What is your primary service role at this assembly?Select valueInterested A.A. MemberGeneral Service Representative (GSR)Alternate GSRDistrict Committee Member (DCM)Alternate DCMDistrict Officer (e.g.: District Chair, Recording Secretary, Treasurer, etc.)Area 11 Special Service Committee Member (e.g.: Public Information, Website, etc.)Area 11 Special Service Committee ChairArea 11 Special Event Member (e.g.: Rompiendo Fronteras/Breaking Frontiers, CSCYPAA, etc.)Area 11 Special Event ChairArea 11 Officer (Imd. Past Delegate, Delegate, Alt. Delegate, Chair, Treasurer, Alt. Treasurer, Recording Secretary, Registrar)Area 11 Past DelegateAl-Anon Delegate, Alternate Delegate, or OfficerGuest District #Select valueGuestArea Committee123456789101112131415161718192021222324252627282930 I will be attending:OnlineIn PersonSubmitReset
