District 21 Inventory Survey Form

Please complete the following questionnaire to help us with our District Inventory (Self-Assessment).

Your feedback will be sent to your home group’s GSR.

If you do not have a homegroup, or if your homegroup does not have a GSR, please select the most appropriate option and your feedback will be reviewed by the Committee. This will ensure your feedback is heard.

The contact information is completely optional. Please provide it if you want to be contacted.

Thank you for your service!

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Name

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Last

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Phone

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Would you like someone to contact you regarding this survey?

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• No

If you select “Yes,” please provide your contact details above.

What is your Home Group? *I don’t have a home groupMy group doesn’t have a active GSRI don’t know who my GSR isRoom with a View11th Step MeetingAlbany Group 1Alsea BreakfastAs Bill Sees It – Women’sAttitude of GratitudeBy the River GroupChannel of PeaceCommon Peril Men’s Book StudyCorvallis Men’s GroupCorvallis Young Peoples GroupExperience, Strength & Hope – CorvallisExperience, Strength & Hope – LebanonGrace In Solutions Women’s GroupHappy HourLearning to LiveLebanon Noon GroupLebanon Original Group-Harden HallNo Loop Holes Women’s GroupPhilomath Open GroupRainbow ConnectionRoom with a ViewRine & ShineSober SolutionsSober StudioStark Raving SoberSunday SOTOSweet Home SurvivorsThe Meeting in the ParkToday GroupToday Online Women’s Group(Corvallis) UndergroundWillamette Valley Dog on the RoofWomen’s Primary PurposeWomen to WomenZoom at Noon GroupZoom with a View

If your homegroup has a GSR it will appear in this list. If you do not have a homegroup, or if your homegroup does not have a GSR, please select the most appropriate option and your feedback will be reviewed by the Committee.

1. What is the primary purpose of District? Is District fulfilling that purpose? What could District do better?

2. How well does District communicate with groups in the District and with AA as a whole? What can District do better?

3. What is District doing to encourage fellowship and interaction among groups? What can District do better?

What reaching District

4. How effective is District at communicating and interacting with the community as a whole outside of AA? (Consider the work of the Hospitals and Institutions and Public Information committees, the District website and hotline, and connections with other organizations that support alcoholics who still suffer.) What can District do better?

5. Is District effectively attracting people to general service such as GSRs, district officers, and committee chairs? What could District do better?

6. Does District do enough to train new GSRs, officers, and committee chairs? What activities or workshops might be helpful?

7. Are District meetings informative, efficient, and effective in conducting business? What suggestions might make meetings run better?

8. How well does District form an effective group conscience when voting on district matters in the spirit of Tradition 2? What could District do better?

9. Are District funds being used effectively and responsibly to support groups and to meet AA’s primary purpose of reaching the alcoholic who still suffers? What could District do better?

10. What can District do to encourage groups to contribute to the financial support of District 21, Area, and GSO?

11. Is the District 21 website effective and user friendly? What could be improved?

12. Do you have any other questions, concerns, or comments regarding District 21?

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