Assembly Registration with check

ASSEMBLY REGISTRATION 
and payment with check



We require contact information so we can communicate with you about the assembly. We never share this information with anyone else. See our Privacy Policy for more information.

   Representative    Alternate Representative    Visitor

 

Thank you for offering information about your stay. This will help us better accomodate you.


 Yes    No

 Yes    No

 Yes    No

  Grilled Chicken Caesar Salad
  Sauteed Spinach with Chicken
  Sauteed Spinach with Tofu


 

Please let us know in order of preference which committee you would like to participate in. For a description of each committee and its purpose visit our committee page.



 Bylaws
 Diversity
 Intergroup Outreach
 Public Information
 Twelve Step Within
 Young Persons
 Not Applicable - I'm a visitor

 Bylaws
 Diversity
 Intergroup Outreach
 Public Information
 Twelve Step Within
 Young Persons
 Not Applicable - I'm a visitor

 Bylaws
 Diversity
 Intergroup Outreach
 Public Information
 Twelve Step Within
 Young Persons
 Not Applicable - I'm a visitor

 

Please provide us with your intergroup contact information.


If you are a Representative or Alternate Representative, have you been duly selected by your Intergroup to serve at the Region 2 Assembly and will your Intergroup Chair and Secretary confirm this, if needed?

 Yes    Not Applicable - I am a visitor

 

Bring check to the assembly.

Check must be recieved 30 days prior to the Assembly date.



 

Submit this registration form then bring a check for $29 made payable to 'Region 2 - Ass'y Registration' to the assembly.

Submit this registration form then cut a check for $45 made payable to 'Region 2 - Ass'y Registration'.

Mail the check to the address below:

OA Region 2
4733 Torrance Blvd, PMB 335
Torrance, CA 90503