12 Step Sign Up Form

“I am responsible …
When anyone, anywhere, reaches out for help,
I want the hand of A.A. always to be there.
And for that, I am responsible.”


The 12th Step volunteer performs a vital role for the alcoholic in crisis.  You can provide support and a message that can only come from a fellow alcoholic.  Whether on the phone or in person, your service is invaluable to not only the caller but also to your own program of recovery.

The information contained in the following form will only be used by the Central Office Manager as well as phone volunteers/webmaster where appropriate.  Even if you have filled this out in the past, please send it through again as our database is starting fresh.  You will be contacted by the 12 Step coordinator to  schedule your availability.

Your Name (required)

Your Email (required)

Subject

Your Phone Number (required)

Your Home Group

Do you have a car?

Available Day or Evening?

# of Years Sobriety

Areas Willing to Travel
 Airport Moanalua Waikiki Downtown Manoa Aina Haina Hawaii Kai Waimanalo Kailua Kaneohe Ka'a'wa Kahalu'u Hau'ula Laie Kahuku Haleiwa Mokuleia Makua Makaha Waianae Nanakuli Ko'olina Kapolei Ewa Beach Waipahu Milialani Wahiawa Wailua

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