AMIAS Reference Form
This form is to be used by references for new Alateen Member in Al-Anon Service (AMIAS) applicants. Two references are needed for each person applying to be an AMIAS.
Submission Date
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Month
-
Day
Year
Date
AMIAS Applicants Name (for whom you are providing the reference)
First Name
Last Name
Your Name (reference provided by)
First Name
Last Name
Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Phone Number
-
Area Code
Phone Number
Your E-mail
example@example.com
How long have you known the applicant?
Are you the applicant's Al-Anon sponsor?
Do you know if the applicant has worked, or in the process of working the 12 steps of Al-Anon and is familiar with the traditions and concepts of the program?
Would you recommend that the applicant become an AMIAS (AlateenMember in Alateen Service)?
Comments
Submit
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