Speaker Sign-Up

Speaker Sign-Up
By completing and submitting this form, you agree to follow the Members Interested in Speaking (G-1) guidelines and to be available as a speaker for District 12 Al-Anon Family Groups looking for speakers. The information you provide will be shared with meetings that request a list of available speakers. If your information changes, please send your changes to grouprecords@alanonventura.org.
Name
First Name, Last Initial
Email Address
Phone Number
Format: (000) 000-0000.
Location (City)

Street Address

Street Address Line 2

State / Province

Postal / Zip Code
Preferred contact method (select all that apply)
When did you join Al-Anon?

MonthDayYear
Years in Al-Anon
Are you currently working with an Al-Anon sponsor?
I’m willing to speak at (Check as many as apply)
Languages in which you are fluent and are willing to speak
For in-person meetings, do you have any travel restrictions or accommodation needs?
Reply N/A if this doesn’t apply
What is your home meeting?
Include Day and Time
What is the Al-Anon focus of your shares? (Check as many as apply)

Other
Additional information you’d like to share
Please verify that you are human
Submission Date

MonthDayYear
Date
Hidden Years in Al-Anon
Should be Empty: