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Read The Big Book and Twelve and Twelve

Online Forum Registration

Please fill out the form and press the Send button to register

(Information collected is confidential and will only be used for communication about this Regional Forum.)

First and Last Name:

How would you like your name to read on your badge? (For Example:  First Name and Last Initial; First and Last Name; Nickname; etc.)

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1. Are you a French-speaking member who requires translation?
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2. Are you a Spanish-speaking member who requires translation?
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3. American Sign Language interpretation is available upon request. Please contact

4. Have you ever attended a previous Regional Forum?
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5. Do you want to receive the Final Forum Report electronically? If yes, please provide your e-mail address: