Area Service Committee Registration / update Form
Thank you for updating your ASC’s contact information with NA World Services. 
Area Committee Mailing Address (Please print clearly)
Committee Name	Today’s Date	
Address/PO Box	
City	State/Prov	Zip/Postal	
Country	Webpage URL address	
Area Helpline Number (            )	Helpline is based in what city?	
Committee is in which Region?	
How many NA groups?	How many NA meetings?   	Committee was formed in month/year?	
Area Service Committee Contact 
This is typically contact information and a mailing address of a stable NA member who can forward any communication from 
NA World Services to the ASC. This may or may not be a current ASC trusted servant. NA World Services frequently receives requests 
for contacts from professionals; this information will help us to better respond to those requests.
Name	
Address	
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address	
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
Area Service Office Address (if applicable)	
ASO Name	
Address	
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Contact Name 	
NA World Services maintains contact information for the following trusted servants and subcommittees: Activities, Convention, 
Hospitals & Institutions, Literature Distribution, Literature Review, Meeting List, Newsletter, Phoneline, Public Information, and Website.  
Please use the following section to forward any of the above contact information.	
Name	Position 	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
	
Name	Position	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
	
Name	Position 	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
		
Name	Position 	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
		
Name	Position 	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish	
	
Name	Position 	
Address		
City	State/Prov	Zip/Postal	
Country	Phone (              )	
Email Address		
Send me The NA Way Magazine – (circle one)  Paper  or  Email    (circle one)  English   French  German   Portuguese   Spanish