ARCHIVES C.A. AREA HISTORY QUESTIONNAIRE Form – Cocaine Anonymous® World Service

Please help the C.A. World Service Archive Committee keep a historical record of C.A. Areas around the world. Please answer in as much detail as possible the following C.A. Area History questionnaire. Use this form and take as much space as you require to fully answer the questions.

Area History Form

Date of Submission *

Your Name

Your Phone Number

Your Email

Your C.A. Area Position

What is the name of your area.

Is your Area incorporated?

Yes

Do you have a copy of your origianl incorporation documents?

Yes

What C.A. Region does your Area belong to?

When did the first C.A. Group appear in your Area? What was the name of the first C.A. group in your Area?

When was your Area ratified at Conference? (Year?)

At ratification: How many Districts were there in your Area?

At ratification: How many Groups were there?

Today: How many Districts are there in your Area?

Today: How many Groups are there?

Did any other Areas spin off from your Area? If so, please elaborate.

Do you keep Area Committee records? i.e. minutes, meeting lists, directories, etc?

Yes

Does the Area hold social or special C.A. related activities (Conventions, Celebrate Around the World, etc.)?

What city does your Area Service Committee meetings take place? Has it changed over the years

How many C.A. members are there in your Area? (approximately)

Has C.A. membership, meetings and groups in your Area increased or decreased over the years?

Does your Area have a website and if so, what is the web address?

Can you provide a map of your C.A. Area showing its geographical boundaries?

Yes

Does your Area have an Archives Chair? If so, please provide a name, email address and phone number.

Does the Area have any particular customs, traditions or interesting anecdotes to share? If so, please elaborate.