Registration Form

CERAASA/ASTECAA 2025

Canadian Eastern Regional Alcoholics Anonymous Service Assembly

Area 82 Nova Scotia/Newfoundland/Labrador

February 21, 22, 23, 2025 Dartmouth Nova Scotia

English Registration Form

Name *

First

Last

Email *

Name on Badge *

Area *

Phone Number *

111-111-1111

Street Address *

Addition Address (unit, APT #, Box)

Town/City *

Province/State *

Country *

Postal Code/Zip *

Service Position

Past Delegate

Please State Area and Panel Number

Other Service Position

If none of the above fit.

Please select which ones apply to you....

Do you want to help with English/French translation during CERAASA

Comments / Addition requirements / Special Needs

Do you Require Vegetarian?

Please Check All That Apply--(1 Registrant per form) *

Please use 1 form per Registrant. Guest is for the Banquet only.

Total *

$0.00

Payment *

E-Transfer to: - Password for e-transfer: CERAASA

Any comments, Questions or Concerns

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