DCM and Alt-DCM Change Form

District Committee Member (DCM) and Alt DCM Change Form

This form allows groups to inform the area and GSO of their General Service Representative changes.

GSO(Required)

Area # District #

Date

District Number(Required)

District #

District Meeting Format(Required)

In-Person Only

Virtual Onluy

Hybrid – both in-person and virtual

DCM Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

New DCM Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous DCM Name (if not known leave blank)

First Last

Alternate DCM Name

First Last

Alt DCM Email

Enter Email Confirm Email

Alt DCM Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

This field is for validation purposes and should be left unchanged.