What is the name of your group?

Organization Name

Write a brief (one to three sentences) description of your organization.

How would you categorize your organization (for example: support, children, self-help,  parenting, hobby,special interest)?

In what county are your meetings held?

Barbour  Harrison Lewis Marion
Monongalia Preston Taylor Upshur
We meet in different places

Organization Contact Information:

                                Web Site        
                      E-Mail Address
City where meetings are held

If you do not have an e-mail address and wish to have the organization's phone number and/or address listed, enter it here:

Telephone number
Mailing Address   
                    City     
                    State West Virginia  Zip

Tell us how to get in touch with you:

Name     
E-mail   
Tel      
Address  
City     
State	 West Virginia  Zip 

My organization does not have a web site. Please contact me concerning creating a web site.