Bridging the Gap – Volunteer Registration Form

Many A.A. members can tell you that, even though we were aware of A.A. we were too fearful to go alone. In order to Bridge the Gap between Facility (treatment & corrections) and A.A., individual members have volunteered to be Temporary Contacts.

Download a printable copy of this form.

Bridging the Gap - Volunteer

Name *

(email phone /

Preferred Contact (email or phone number) *

Alternate Contact (email or phone number)

Sobriety Date *

Home Group *

I am willing to bridge members from: (check one or both) *

• Treatment
• Corrections

What are your pronouns? (select all that apply) *

• She/Her/Hers
• He/Him/His
• They/Them/Theirs

Message / Comment

Submit