NCWSA 2023 Hybrid Election Assembly Pre-Registration Form

HYBRID ASSEMBLY PRE-REGISTRATION

This Assembly abides by NCWSA's Alateen Safety & Behavior Requirements (B-17)

Event AMIAS – Karen PM. And Pauline R.

In keeping with B-17, Alateens must select the appropriate box while completing this form by October 3rd, 2025 . Your registration will then be forwarded to the following AMIAS:

Sara E, NCWSA Alateen Area Coordinator alateencoordinator@ncwsa.org

To Pre-Register ONLINE: Complete this form then select the "Submit Form" button at the bottom of the form after selecting (In Person) or (Online).

To Pre-Register vial MAIL: Select the "Print Form" button at the bottom of this form. Complete the form, and include "Reg-Fall '25 Assembly" on the check or money order. Please make your check payable to the NORTHERN CALIFORNIA WORLD SERVICE AREA OF AFG INC or NO CA WORLD SERVICE AREA OF AFG INC. Please do not abbreviate the name to NCWSA. Mail the form and your check to

Assembly Pre-Reg
c/oLisa K. - Pre-Registration
4137 Wheat Street
Sacramento, CA 95821
NCWSA October Assembly

Maidu Community Center 1550 Maidu Drive Roseville, CA
Alateen Registration

Select if you are Registering as an Alateen
Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone *
Home Group
District*
We now use the WSO number as the voter ID. Only one member of your Group is allowed to vote. That member would be the GR or the Alternate GR. The WSO field is set not required however it must be unique. If more than one member of your group attempts to enter the WSO Number it will create an error. In the event you do not know your WSO you may contact grouprecords@ncwsa.org.
Positions *

GR or Alt GR (Voting)Alt GR (Not Voting)DR or Alt DRArea Coordinator or Alt CoordinatorArea OfficerDesignated Assembly AMIASOther (Past Delegate, Liaison, Intergroup Rep)Guest
WSO Number (Required for Voting)
Is Spanish Interpretation requested?

Yes
Please indicate your preference

TurkeyBeefVegetarian
I will attend the assembly

In Personvia ZOOM

Assembly Registration *

Al-Anon Registration (In-person or Zoom) $60.00

Registration includes Saturday Lunch.

Total $0.00

Credit Card

- Once you submit your form you will be launched to a zoom registration site. You must, I repeat you must used the email address you will be using the day you join the meeting.
- You will receive your Zoom log-in information for the Assembly once you complete your Zoom pre-registration which is additional to the process you are engaged in now. Please verify you have correctly entered your email address as you will login during the Assembly. You must match your Zoom registration with the Zoom Login on Assembly day.
- Any group needing financial assistance to attend may contact the NCWSA Treasurer, Bob S. at Treasurer@ncwsa.org after first reaching out to your district for travel assistance.
- For Pre-Registration questions, email . Include the words "Pre-Reg Question" in the subject line.
IT WILL BE GOOD TO GATHER AGAIN! NCWSA THANKS YOU FOR YOUR SERVICE!
We look forward to seeing you in Roseville.

Any group needing financial assitance can contact the NCWSA Treasurere, Bob S., at Treasurer@ncwsa.org after first reaching out to your district for funding.

For Pre-Registration questions please reach out to your DR, Facilities Coordinator at facility@ncwsa.org or Lisa K. - Pre-Registration lisakovakovich@icloud.com with PRE-REG Question in the subject line.

IT WILL BE GOOD TO GATHER AGAIN.
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NCWSA October Assembly

Credit Card