AREA 16 DISTRICT OFFICERS

DISTRICT___________ DCM Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________	ZONE ___________ DATE __________ PI Representative Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________
Alt DCM Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________	Correctional Fac. Representative Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________
Secretary Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________	Treatment Fac. Representative Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________
Treasurer Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________	Grapevine Representative Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________
CPC Representative Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:_______________________	Other Name_________________________________ Address_______________________________ City, State, & Zip ______________________ Telephone ( )________________________ Email Address:________________________

GSSA

P.O. BOX 7325

MACON, GA., 31209

PLEASE COMPLETE AND RETURN TO GEORGIA STATE SERVICE ASSEMBLY (GSSA) AS SOON AS POSSIBLE.

Deadline for next Georgia State Directory – December 1^st.