VCI Group Information Update Form

Volusia County Intergroup

345 Beville Road, Suite 102
South Daytona, FL 32119-2147

(386) 756-2930 local
(888) 756-2930 toll free (from 386, 407 & 904 area codes)
(386) 756-3573 fax

OFFICE HOURS: Monday - Friday: 9 am - 5 pm
Saturday: 9 am - 1 pm

Update your Group Information Fields marked with a * are required

Group Information
* Group Name:		ie: Daytona Beach Group
* Meeting Place:		ie: St. Pauls Church
* Street Address:
* City:

Group Contact Information

* Contact Person's Name:		ie: John Doe
* Address:
Address 2:
* City:
* Zip Code:
* Phone:
Phone 2:
E-Mail Address:

Intergroup Rep Contact Information

IGR Contact Person's Name:		ie: Jane Doe
Address:
Address 2:
City:
Zip Code:
Phone:
Phone 2:
E-Mail Address:

Please NOTE: After receiving your information, you will be contacted within 1 week of your
submittal to verify that we have received and updated our records accordingly. If you are
not contacted, please contact us at 386.756.2930. Thank You.