Untitled 1Alcoholics Anonymous District 58

Welcome to District 58 Area 59 AA


Serving Schuylkill & Southern Northumberland Counties in

Northeastern Pennsylvania



Need Help?

Call Our District Hotline At:
1-800-659-4558


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To contact the District email:
webmaster@district58area59aa.org
 


Area 59 (Includes the Eastern half of the state of Pennsylvania)

THE A.A. CORRECTIONS PRE-RELEASE

CONTACT PROGRAM REQUEST FORM

-PLEASE PRINT CLEARLY-

 

MALE         FEMALE                          AGE                     DATE_______

NAME                                                                               ID#_________

CURRENT MAILING ADDRESS

FACILITY______________________________________________

STREET_______________________________________________

CITY__________________________STATE            ZIP_________

ADDRESS BEING RELEASED TO (HOME ADDRESS)

NAME_________________________________________________

STREET________________________________________________

CITY__________________________STATE________ZIP________

PHONE_________________________________________________

RELEASE DATE_________________________________________

Phone Contact:__________________________________________

PREFER SPAN ISH SPEAKING? YES__________NO__________

MAIL COMPLETED FORM TO:  LV Center, AA District 58

502 South Second Street, St. Clair, PA  17970 

OR EMAIL TO:  WEBMASTER@DISTRICT58AREA59AA.ORG