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K A S B
GRN Form





            1420 SW Arrowhead, Topeka, KS (800) 432-2471: Fax (785) 273-7580 Updated 12.12.03

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This form will allow you to sign up for the KASB Governmental Relations Network. Please fill in the information and click the Send It! button.

After clicking the Send It! button a new screen will appear showing the information you entered into this form. If you do not see this new screen, your form was not sent to KASB.

Name:

District Title:

USD Name/Number:

Mailing Address:

City/Zip Code:

Home Phone:

Work Phone:

Mobile Phone:

Fax:

E-Mail Address:



Please Check All the Following that Apply:
 
Appointed to serve as representative to GRN
 
 
I wish to receive my "Bulletin" by mail
 
 
I wish to receive my "Bulletin" by E-mail
 
I Wish to Join the GRN
 
 
I wish to receive my "Bulletin" by E-mail
(There is NO CHARGE to receive the "Bulletin" by e-mail)
 
 
I wish to receive my "Bulletin" by mail (PLEASE NOTE: A $40 subscription fee will be billed to the district)


OPTIONAL INFORMATION:

Your State Representative:

Your State Senator:

Your State Board of Ed Member:

U.S. Representative:

List any personal political involvement on your part, relationships with elected
officials and other relevant information:



After you click the Send It! button a new screen will appear showing the information you entered into this form. If you do not see this new screen, your information was not sent to KASB.

THANKS FOR SIGNING UP FOR THE GRN
Please note: Although it is unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your your information to to KASB Legislative Staff.