Anniversary Meeting Registration

NYCMA Anniversary Meeting Registration
Please complete this form to register for the monthly anniversary meeting.

The next celebration, for April celebrants, will be held
Monday, August 4th, 7:30 pm at The Center
208 W 13th St, Room 301 | New York, NY 10011

The anniversary meeting is now in-person—not hybrid.
Your name*

First NameLast Initial
Pronouns
Your email address*
Phone Number*

Area CodePhone Number
Sobriety Date*

MonthDay Year
Number of years you're celebrating*
Who will be presenting your medallion?*
EACH CELEBRANT CAN HAVE ONLY ONE COIN PRESENTER.
Should be Empty:

NYCMA Anniversary Meeting Registration