Group Registration Form
We'll use this data to add or update your group entry on the CoDA Meeting List
Meeting Name
*
Registration Type
*
New Group
Update Group Details
Meeting Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of First Meeting (for new groups)
-
Month
-
Day
Year
Date
If in a Country Area closest Town/City
Meeting Day of The Week
Please Select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Meeting Frequency
Weekly
Fortnightly
Monthly
Other
Start Time
Hour Minutes
AM
PM
AM/PM Option
Meeting Duration
Meeting Type
Open
Closed
Step
Topic
Other
Does this group use only CoDA endorsed literature?
Yes
No
Directions to Venue
This will be added on a separate page from you Meeting List entry and will give new members information on how to find your meeting.
Venue Accessibility
Level Access
Nearby Parking
Disabled Toilet
LIft
Escalator
If the meeting day falls on a public holiday will the meeting run:
Yes
No
Call to Check
Keep in Contact with the National Service Office and the CoDA Fellowship
Please note: one contact person's details are required.
Contact One Name
*
First Name
Last Name
Contact One Email
*
example@example.com
Contact One Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Display Contact Details on Meetings List?
Contact One Email
Contact One Phone
Contact Two Name
First Name
Last Name
Contact Two Email
example@example.com
Contact Two Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Display Contact Details on Meetings List?
Contact Two Email
Contact Two Phone
Meeting Details (this will appear on the Details section for your meeting - contact details will be added as per data above)
Submit
Should be Empty: