OFFICIAL FORM TO START AN SIA MEETING
SIA Tradition 4: Each group should be autonomous except
in matters affecting another group or SIA as a whole.
return to: / Survivors of Incest Anonymous
World Service Office, Inc.
P. O. Box 190
Benson, Maryland 21018-9998
(410) 893-3322
Email:
Qualifications: /
- You should be at least 18 years old.
- You should be willing to commit yourself to the group for at least 6 months, if possible.
- You must be willing to follow the 12 Steps and 12 Traditions of S.I.A.
Note: / PLEASE DO NOT PHOTOCOPY any SIA literature or type it on the Internet since this violates federal copyright laws and deprives the W.S.O. of much-needed funds.
It is preferable that you have 12-Step experience. If not, we suggest you familiarize yourself with 12-Step literature.
Important! / It is important that your meeting be registered, and that you keep us up-to-date on information. We get calls and letters from survivors around the world.
If your meeting is registered, we can:
Refer survivors to the closest appropriate meeting
Send your group the quarterly World Service Bulletins to keep you informed about issues, new groups, and new literature.
Include your group in yearly surveys to contribute your vote to policies affecting SIA groups. Note that each group is autonomous, so all policies are suggested, not mandatory.
If your meeting changes location or time, or if it disbands:
Let us know as soon as possible.
It is customary for groups to contribute 25% of their donations to SIA World Service Office to help pay rent, printing and copying costs, phone, insurance, attorney, and accountant bills.
Thank you for your cooperation and in helping your WSO help others!
Please complete and return this portion (and keep a blank copy to send us every time you make meeting changes )
Contact / Name / Street:
City, State, Zip
Phone # with Area Code:
Permissions / May we provide your first name and phone number to survivors who call our Information Line?
/ Yes, please do / / No, please do not.
May we include your first name and phone number in the SIA International Directory?
/ Yes, please do. / / No, please do not.
May we email your first name and phone # as a response to survivor requests via the Internet?
/ Yes, please do. / / No, please do not.
1st Contact signature (Required) / Date:
2nd Person / Name / Street:
City, State, Zip
Phone # with Area Code:
Permissions / May we provide your first name and phone number to survivors who call our Information Line?
/ Yes, please do / / No, please do not.
May we include your first name and phone number in the SIA International Directory?
/ Yes, please do. / / No, please do not.
May we email your first name and phone # as a response to survivor requests via the Internet?
/ Yes, please do. / / No, please do not.
2nd Person signature / Date:
Meeting Address / Building: / Addr:
City, St, Zip
Which Day? / Time:
Direction
Meeting Permissions / May we email your meeting location (only) as a response to requests via the Internet?
/ Yes, please do. / / No, please do not.
Would you like the meeting location (only) posted on the SIA website?
/ Yes, please do. / / No, please do not.
Other info you'd like in the directory, on the website or emailed to survivors? / ______
Restrictions / Does your meeting have any restrictions or requirements? Please check all that apply:
/ Women Only / / Men Only / / Multiple Personalities Only ( D.I.D.)
/ No Smoking / / Wheel Chr Access / / Only Survivors who were abused by women
/ Other - explain:
PLEASE DO NOT USE THIS FORM TO REPLACE ANOTHER GROUP BECAUSE BOTH GROUPS WILL APPEAR ON THE
DIRECTORY OF MEETINGS AND SURVIVORS WILL BE DIRECTED TO A MEETING THAT NO LONGER EXISTS!
Do you want us to exclude your first name / phone # we send regular mail, or call, in response to Internet requests?
It's OK to send my first name and phone number. Exclude my first name and phone number
Please understand that if you chose to be excludedit means that your first name and number will be deleted from
ALL published lists. The group will still be listed, but there will be no contact person for a survivor to call.