AA/NA Meeting Attendance Sheet: Printable PDF for Court

AA / NA Meeting Attendance Sheet

1. Participant and Case Information

Participant Name: [Full Name]
Court / Agency / Program: [Name of Court, Probation Department or Program]
Case / Docket Number: [Case Number]
Probation Officer / Counselor: [Name and Phone or Email]
Meetings Required: [Total Number, or Number per Week]
Period Covered: [Start Date] to [End Date]

2. Instructions

• Bring this sheet to every AA, NA or similar support meeting.
• Before the meeting starts, ask the group secretary or chairperson whether the group signs attendance sheets. Each group decides this for itself.
• Fill in the date, time, group name and location of each meeting in ink.
• At the end of the meeting, ask the secretary or chairperson to print a first name and sign or initial your row. Do not fill in the signature column yourself.
• For more than 18 meetings, use another copy and continue the numbering. Keep all pages together and keep a copy for yourself.

3. Meeting Attendance Log

#	Date	Time	Group / Meeting Name	Location or Online Platform	Secretary or Chair (Print)	Signature / Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

4. Participant Certification

I, [Participant Full Name], certify that I attended each meeting listed above on the date shown and that the information on this sheet is true.

Participant Signature: ____________________
Date: [Date]

5. Reviewed By (If Applicable)

Officer / Counselor Name: [Name]
Title / Agency: [Title / Agency]
Signature: ____________________
Date of Review: [Date]