ATTENDANCE AT 12 STEP MEETINGS

I am required to attend 12 Step Meetings:
____ Once a week						A.A. _______
____ Twice a week						N.A. _______
____ Once a month						G.A. ________
____ Twice a month						CODA _______
____ Other:  __________________________			OTHER ______

Verification of attendance for the month of: _________________________________

DATE		                MEETING NAME		             SIGNATURE VERIFYING ATTENDANCE
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________
_________ ________________________________________ __________________________________

My Name: _________________________       My Signature/Date _______________________________