NSB – IIG Registration

This form is only for the use of our National Service Boards or International Intergroups to use for re-registration or to make changes to the Board’s information. Those updating information (Location or Chair changes) should be sure to first check “Re-Registration”

The * Indicates Required Information –

♦PLEASE NOTE THAT LAST NAMES USED ON THIS FORM ARE NOT FOR PUBLIC DISCLOSURE AND ARE USED FOR MAILING OF MATERIALS IN ACCORDANCE WITH TRADITION 12.♦

(Instructions – Use the “TAB” key to move between fields on this form. Using the “ENTER” key without completing all required fields will cause you to have to enter all information from start)

Group Registration

* Registration Reason
Re-Registration

New NSB / IIG

Group Closed

Type of Change
Chair Change

Other Information Change

Group Number

* Office Street Address

* Office City

* Office State/Province

Select a Country

* Postal/Zip code

* Office Phone Number

* Office Email Address

Group Web Site Address

* Full Name of the Chair

* Chair's Email Address

* Name of Liaison to the WSO

* Liaison's Phone Number

Liaison's Email

Additional Comments or Information

* Type the numbers.

Updating...

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