Your full name:
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
Email Address:
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
Job Title: (be specific)
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
Job Location: (agency or organization)
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
Mailing Address: (street, city, state & zip code)
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
Telephone:
![bullet](https://webarchive.library.unt.edu/eot2008/20081008142354im_/http://www.nal.usda.gov/wicworks///bullet.gif)
The WIC-Talk list administrator will not provide names, address and email information to other mailing lists.