This form should be completed after each meeting and forwarded to the A.W.A.K.E. Network Director at the ASAA: 888-293-3650 (fax).

A.W.A.K.E. Group________________________________________________________________

Date of Meeting __________________________________________________________________

Meeting Location_________________________________________________________________

City____________________________________________ State ________________

Number Attending _____ people affected by sleep apnea and their family and friends

_____representatives of sponsors

Featured Speaker/s ___________________________________________________________

Topic Presented ______________________________________________________________

Please add any comments and/or suggestions about this meeting and your group, particularly if they would be interesting to share with other A.W.A.K.E. groups.

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________