Print this form, fill it out and send it to:
	MOREnet                                Or   FAX: (573) 884-6673
	c/o Systems and Programming Manager 
	3212 LeMone Industrial Blvd.
	Columbia, MO 65201

I request readership access to the MOREnet USENET news server for the following people:

Name or Organization                      IP Address

_____________________________             _________________________________

_____________________________             _________________________________

_____________________________             _________________________________

I understand that the access will be limited to these individuals only.

I understand that some of the material contained in this feed can be considered offensive
and inappropriate for minors and take responsibility for limiting this type of access
in my organization.

Signed,



____________________________
Signature of Governing Board representative, superintendant, library director or 
agency head



____________________________
Name (typed or printed)



____________________________
Organization represented