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TreatmentFacilities Sign-up Sheet

Treatment Facilities Sign-up Sheet

for members willing to Serve on

the District Treatment Facilities Committee

If you are willing to be a member of the

Treatment Facilities committee, give your name, telephone number, sobriety

date, email address and your district. Your local Treatment Facilities

contact person will contact you for more details.

   
Name:

Phone

Number:

Sobriety

Date:

Email

Address:

District: