Attendance Record for Alcoholics or Narcotics Anonymous Meeting
Name: ______________________
The above named individual is to attend Alcoholics/Narcotics Anonymous meetings. We will appreciate a member of the group
signing this record of attendance at the end of each meeting. The applicant is expected to fill out all the columns with the
expectation of the signature columns. You cooperation is greatly appreciated.
AA/NA Meeting
Time
Date
Topic/Speaker
Signature of Chair Person or
designee
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THIS FORM TO BE PLACED IN CASE FILE UPON COMPLETION
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