The Briar Bunch - Briar Bunch Application

Saturday, July 31, 2010

Non Est Vivere Sed Valere Vita ~ Life is more than merely staying alive..

Briar Bunch Application

Interested in joining The Briar Bunch? It's easy!

The first year membership fee is waived for Briar alumni and nominal for anyone else interested in belonging. Membership benefits include greatly reduced rates for Briar events, member access to this website and great fellowship in recovery!

Simply fill out the form to apply for membership. We will contact you to arrange dues payment (where applies) upon receipt of the application. You can also download the application, fill it out and send it to: The Briar Bunch, P.O. BOX 60982, Pasadena CA 91106.

Please Note: This application is NOT connected with the website logins themselves. After you have been accepted to the Briar Bunch you'll want to SIGN UP an online account.

Sobriety Date:	( format: mm/dd/yyyy )
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
ZIP:
Email Address:
Day Phone:
Evening Phone:
Your Drug(s) of Choice:
I can help on one of the following committees (check all that apply):
	Social Events Support Speaker Panels
Suggestions for Activities:

Would you be willing to contact a Briar patient/graduate who needs support from someone with the same drug of choice?:
Yes No	Days & Hours available:
First year membership dues are free for Briar graduates. Annual dues are $10, payable in September. All are invited to join and participate regardless of whether you are a Briar graduate or not.
Any comments or questions?:

» MEMBER LOGIN

LOGIN ID:
PASSWORD:

forgot your password?

» SITE MENU

[ home page | contact us | privacy policy ]