AA Meeting Attendance Verification Form

A court-compliance form used to confirm that a defendant attended an Alcoholics Anonymous meeting, recording meeting details and signatures from the group leader and attendee.

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Name of Defendant

Nombre

Apellido

Name of Officer (If Known)

Nombre

Apellido

Group Name

Group Reference Number (If Known)

Meeting Duration

Date of First Meeting in This Group

Address of Meeting

Dirección

Ciudad

Estado / Provincia

Código postal

Was It an "Open" Meeting?

Yes No

Please Give Details

Helpline Phone Number

Group Contact Information

Name 1

Nombre

Apellido

Phone Number 1

Name 2

Nombre

Apellido

Phone Number 2

Group Email Address

Group Leader Name (If Known)

Nombre

Apellido

Additional Information

Signature of Defendant

Sign here

Signature of Group Leader

Sign here

AA Meeting Attendance Verification Form

Group Contact Information

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