Monticello Avenue Mailing List Application

1. Name of Organization:

2. Monticello Avenue User Id:

3. Name of person who will maintain the list:

Phone:

4. Preferred List Name:

5. Initial Password for list:

6. Should the list be: 

_____Open

_____Closed

7. Describe purpose of list:

As an official representative of 

 ____________________________________________________________
I understand and will abide by the policies established by the Jefferson-Madison Regional Library Board of Trustees and agree to notify Monticello Avenue should I choose to relinquish ownership of this mailing list.

Please return completed form to: