U.S. and Canada
A.A. District Committee Member &
District Committee Member Chair
Change Form
Outgoing DCM (District Committee Member)
District: __________ (Please indicate District #)
District Language
: English Spanish French
Name:
Address:
City:
State/Province:
Postal Code:
Email:
Telephone:
Home Business
Incoming DCM (District Committee Member)
District: __________ (Please indicate District #)
District Language:
English Spanish French
Name:
Address:
City:
State/Province:
Postal Code:
Email:
Telephone:
Home Business
Outgoing DCMC (District Committee Member Chair)
District: __________ (Please indicate District #)
District Language: English Spanish
Name:
Address:
City:
State/Province:
Postal Code:
Email:
Telephone:
Incoming DCMC (District Committee Member Chair)
District: __________ (Please indicate District #)
District Language: English Spanish
Name:
Address:
City:
State/Province:
Postal Code:
Email:
Telephone:
THREE WAYS TO RETURN THIS FORM G.S.O: By
Mail: A.A.W.S., Inc. Attn: Rec
ords Department
P.O.
Box
459, Grand Central Station, New York, NY 10163
Fax to: (212) 870-3003
E-Mail: records@aa.org
Once complete information is entered into the database by GSO or the Area Registrar a
request for a DCM kit will be generated the next business day. Kit contents are available
by selecting the “Information for A.A. Members” tab then selecting “Information for
G.S.R.s and DCMs” on www.aa.org. Please allow 7-14 business days for kit delivery.
F-43
Rev 3/2018
