Twelfth Step Registration Form

Rhode Island Central Service
1005 Waterman Ave.
East Providence, Rhode Island 02914
(401) 438–8860

We wish to be placed on the Rhode Island Central Service Twelfth Step List.

This list is for A.A. members in good standing who are willing to return calls to people who call us asking for help.

These numbers will only be used by Rhode Island Central Service or our professional answering service.

No phone numbers will be given to people who call for help.

We call a member from this list and ask them to respond to the person asking for help. When the member agrees, they are given the telephone number of the persons asking for help. The member responds.

Name:

Sobriety Date:

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Name:

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Name:

Sobriety Date:

City / Town:

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Phone:

Name:

Sobriety Date:

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Name:

Sobriety Date:

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Revised: October 3, 2009