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["NORTHERN LIGHTS AREA OF NARCOTICS ANONYMOUS"]
["GROUP REPORT FORM"]
["The Area Service Committee is ultimately responsible to the Groups it serves. "]
[null,"®",{"$nulls":8},"®"]
["GROUP NAME:",{"$nulls":6},"Today's Date:"]
["Does the group give permission to",{"$nulls":3},"     Yes  ","Does the group give permission to",null,null,"     Yes  "]
["include this meeting on the meeting list?",{"$nulls":3},"      No","be listed in the newspaper?",null,null,"     No  "]
["GSR Name:                                                 New?   Yes   No ",{"$nulls":5},"GSR phone:  ","(               ) "]
["(Need last name for mailing)",{"$nulls":7},"Area Donation "]
["First & Last Name:"]
[]
["Street Address:",{"$nulls":6},"Apt.","$"]
[]
["City, State, Zip:"]
["     Email:",{"$nulls":5},"Can we email Area distributions to you?   Y       N"]
["GSRA Name:                                               New?   Yes   No ",{"$nulls":5},"GSRA phone:","(               ) "]
["     Email:",{"$nulls":5},"Can we email Area distributions to you?   Y       N"]
["Secy Name:                                                 New?   Yes   No ",{"$nulls":5},"Secy phone:","(               ) "]
["     Email:",{"$nulls":5},"Can we email Area distributions to you?   Y       N"]
[]
["PLEASE SHARE WITH THE AREA THE FOLLOWING INFORMATION"]
["Does your Group need any assistance from the ASC?  Please explain."]
[]
[]
["Please share any concerns your Group has regarding the Area Service Committee or sub-committees."]
[]
[]
["Please list any items your Group would like added to the next ASC agenda."]
[]
[]
["Please share any news from your Group or details regarding any upcoming events sponsored by your Group."]
[]
[]
["ONLY provide the following information if this is a new group or the group meeting information has changed:"]
["Meeting Day:",{"$nulls":5},"MEETING TIME:",null,null,"AM","PM"]
["Meeting Place:"]
["Meeting Address:",{"$nulls":6},"City:"]
["Meeting Format:",null," Speaker   Open Discussion   Literature Study",{"$nulls":4},"Is this meeting "," Open",null," Closed"]
["Is smoking permitted in the meeting?",{"$nulls":3},"     Yes  ","Is the meeting location handicap accessible?",{"$nulls":4},"     Yes  "]
[{"$nulls":4},"      No",{"$nulls":5},"      No"]
["Additional comments:  "]
[]
["Please bring completed form to the ASC Meeting or Mail to NLASC, PO Box 16934, Duluth, MN  55896-0934"]

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