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COSA Individual Registration
Welcome
to COSA
COSA's International Service Organization wants to help you get started in
your recovery from the affects of compulsive sexual behavior.
Here's what ISO of COSA can do for you:
1) We can locate the closest registered COSA meeting in your area.
2) If there isn't an active COSA meeting, we can help connect you with
other people in your area who are interested in starting a COSA group.
You
can download the COSA
Individual Registration form to complete and email to info@cosa-recovery.org.
(The questions must be included, along with your answers.)
* * * * * * * * * * * * * * * * * * * * * * *
Please complete the following information (whatever you feel comfortable sharing):
Today's Date:
First Name and Last Initial:
Gender:
Nearest Major City, State (U.S.) or Province, Country:
County of Residence:
Zip code (U.S.):
Phone Number:
Messages OK? Yes ___ No ___
Best Time to Call?
Private
E-mail Address (no one else can access it):
In
what ways do you feel you identify as a sexual codependent/co-addict?
How
do you think this group might be useful to you?
Please check all that apply:
____ I want to know the location of the nearest registered COSA meeting.
____
I would like to be notified if a new COSA meeting is being formed in my area.
____
I would like my name and contact information given out to others who are
looking for support or to anyone having information about starting a meeting in
my area.
____ I want to register as a COSA Group; please send me a group registration
form (Registering as a group means that you will start a meeting and that you
will let us give out your contact info to newcomers so you can tell them where
and when the meeting is held).
____ I want to receive information, when available, about the annual COSA convention held on Memorial Day Weekend.
Note: ISO of COSA does not wish to receive information about individuals without
their knowledge and permission. If you are thinking about filling out this form
for a friend or family member, please do not do so. We encourage you to let the
other person know about COSA, and ask if they would like a copy of the form to
fill out for themselves (Of course if they request assistance, then feel free
to provide it, with the other person's active participation.)
COSA encourages potential new members to seek help for themselves when they are ready.
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or conveyed in any other way without the express written permission of International Service Organization of COSA, Inc.
® Registered Trademark COSA and the COSA logo are registered trademarks of the International Service Organization of COSA, Inc.