Meeting Registration & Update Form | Pills Anonymous

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Meeting Registration & Update Form

Email

Phone

Are you registering a new meeting?

Are you updating an existing meeting?

Meeting Name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Meeting Day

Meeting Time

Meeting Code (If applicable select multiple codes.)

C = closed to pill addicts only

O = open to everyone

H = handicapped accessible

B = babysitting available

M = men's stag

W = women's stag

LGBTQ = lesbian gay bi-sexual transgender queer

Meeting Format

Is This Meeting Being Held In A Private Residence?

Thanks for submitting!

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