Mail List Request Form
Mail list information  
Name of Organization
Contact person
Email address
Telephone Number
 
Domain name (if applicable)
 
Desired List Name
(eg. something@drugsense.org)
Second choice
(if first is already taken)
Desired password:
 
What type of list would you prefer? :
Broadcast (one-way) Discussion (two-way)
Private Public
With digest Without digest
I can manage (add, remove addresses, etc.) the list.
I will need DrugSense to manage the list
 
Brief welcoming letter to be sent to new subscribers:


Add subscribers:
Additional comments or information: