Mainstay Registration Form - Alcoholics Anonymous Aotearoa/New Zealand

Name of person placing order*

E Mail Address of person placing order*

Post Mainstay to (name and address)*

Send Invoice To*

Group Name (if order is for a group)

Contact Ph No (that GSO can contact if there are questions re this order)*

Type of Subscription. Please note you must make payment for your subscription before the mainstay will be mailed.*