Group History Submission Form


Please fill out General Group information:

Group Name:             Group Meeting Street Address:
Group City: Group Zip:
Group Service Number: District Number:
Number of members:

Please fill out your contact information:

Your Name:          Your Phone #:
Street Address:          City:
Zip: Your E-mail Address:

        Please answer the following questions as fully as possible, where they apply to your group history. Not all questions will apply to your group and you may not know the answer to some of these. Please look over the questions and if there are many you don't know, go find the information and then return to this form. When you click on the submit button at the bottom of this form this information will be sent to the Kansas Area Service Office and a copy will be sent to the e-mail address you provided above.
     We realize this form is long so do not start if you do not have the time to complete it.