GSR/DCM Position Change Form Use this form to let the Registrar know the change of a GSR or DCM: General Service Representative (GSR) or a District Committee Member (DCM). Please complete this form and be sure to reach out to our Area 45 Registrar regarding any questions. Email:[email protected] ~ ~ ~ ~ ~ ~ABOUT YOUR CONTACT INFORMATIONContact information provided is shared with your Area 45 Registrar and relevant committees. Your data will NOT be shared outside of A.A.Do you have an A.A.org Account?If you have an account for on-line Contributions or on-line Literature orders, you must use the same FIRST AND LAST NAME and the same EMAIL ADDRESS. This is your personal account record for GSO. Your Group Name* Your Group GSO ID# Your District Full Name of the person leaving the position of GSR/DCM*FirstLast Outgoing Service Position you held*GSRAlternate GSRDCMAlternate DCMMail Contact Email Address of the person leaving the position* Email confirmation* Phone for the person leaving the position_____________________________ Full Name of the New GSR/DCM*FirstLast Your Email Address(1)* Email confirmation* Your Service Position*GSRAlternate GSRDCMAlternate DCMMail Contact Your Primary Phone Type*HomeMobile Your Secondary Phone TYPEHomeMobileDates of Your Service PositionThe Start/End dates usually follow the calendar dates for the Panel start/end dates. This is the dates you are serving in your position. Your Service Start Date Your Service End Date Your Personal Mailing Address Street Address Street Address Line 2 City State Zip CodeAbout Your GSR Kit MaterialsAll of the new GSRs can expect to receive a Digital Kit in their email. This will be sent from GSO. Would you prefer a print version of the GSR Kit mailed to your address?YesThis form will automatically be processed and sent electronically to the Area 45 Registrar. reCAPTCHASubmitReset"The GSRs of the U.S. and Canada are the very foundation of our general service structure. Through the GSR, you can make your group's voice heard at district meetings, area assemblies, and eventually the General Service Conference."General Service Representative (GSR) - Your Group's link to A.A. as a whole.____________________________________________________________________Our Mailing Address:ATTN: REGISTRARArea 45 General ServiceP.O. Box 3724Cherry Hill, NJ 08034
