Intergroup (IG) Info & Update Form

Please complete the information listed below:  *Required field
Today's Date: *
Intergroup Name: *
IG Location: *

Rep Name:
Rep Email:
Rep Phone:
IG Chair Name:
IG Chair Email:
IG Chair Phone:
How many groups are affiliated with your Intergroup: *
Does your IG have a represnetative working with the IGOR Committee? *
IGOR Rep Name:
IGOR Rep Email:
IGOR Rep Phone:
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SURVEY TO ASSESS YOUR NEEDS:
Please mark areas of challenge / opportunity that you would like to discuss (to seek help). *
Other Areas:
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SURVEY TO ASSESS YOUR STRENGTHS:
Does your IG / Committee have any strengths / information to share with the IGOR Committee or other IG: *
Our IG / Committee has other strengths / information to share with the IGOR Committee:
Best IG News / Accomplishments that our IG can share: (Your IG should DO this!)
IG Learnings / Lessons that our IG can share: (Your IG should AVOID doing this!)
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IN CASE WE HAVE TO CONTACT YOU, PLEASE TELL US WHO SUBMITTED THIS FORM:

Form submitted by: *
PROTECTED BY RECAPTCHA:
Submitter's Email: *
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