Intergroup Registration / Change Form

Use this form to register a new intergroup, update an existing intergroup’s information, or request a cancellation with OA’s World Service Office.

Request Details

Intergroup Number*:

Enter zero for new intergroups.

Region Number*:

New GroupChange InformationCancel Group

Submitter Details

First Name*: Last Name*: Email*: Phone Number*: Effective Date*:

Intergroup Details

Name*: Do you belong to a national service board (NSB)?YesNo

If Yes:

NSB Name: NSB Number: Region Number:
If you wish to change National Service Board affiliation, list your new affiliation below:New NSB Name: New NSB Number: New Region Number:

Country*: State/Province: Phone Number*: Email*:

Note: For anonymity purposes, please provide a generic email address.

Website Address:

Phone Numbers

Please include the country code (if outside US/Canada), city/area code and telephone number.

Answering Service: Alternate:

General Area Served

Contact People for business between WSO and Intergroup

Name*: Phone Number*: Email*: Name*: Phone Number*: Email*:

Affiliated Groups

Please enter numbers and cities, state/province (if in US/Canada) and country of all groups affiliated with your intergroup.

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If you do not wish to use this online form, email update@oa.org, and we will send you a form to complete.

Intergroup Registration / Change Form

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