KANS-A-N Calling Card Request Form

Please read the following before filling out the request form:

Kans-a-n calling card The KANS-A-N Authorization Card is issued to state employees who need to make official business calls OFF-NET telephones. KANS-A-N service is available to all OFF-NET users from 24 hours-a-day, 7 days-a-week. General instructions for use are contained on the back of the Calling Card. Please read the detailed instructions received when you take receipt of your card, or see below.

The number on the KANS-A-N Authorization Card is identified with your agency and department. Your calls will be indentified by this number and your agency and department will be billed the cost of each call. Precautions must be taken to prevent the use of this card by unauthorized persons. Make business calls only and keep them short.

KANS-A-N CARD REQUEST FORM
Have you read the above notice, and agree that you have the appropriate departmental authorization and will take all available precautions to protect your card? If so, indicate yes by entering "Y" here:
Requestor's Name:
Requestor's Phone:
Cardholder's Name:
Department Name:
Budget Number to be Charged:
Phone Number to be Charged:
Campus Address (Room No. & Building):
Please choose the type of account paying for the calls	State Funds; Grant Monies; Endowment
Please choose the type of service you wish to have activated	In-State Only; US Only; International
I acknowledge by submitting this request the fact that issuance of this card to me enables me to charge KANS-A-N calls without verification. I will accept total responsibility for all calls charged against this authorization number and for the proper use of this card in conducting departmental state business. Submitting this request also requires that I appear in person to pick up my card and sign this request form in room 1014 Taylor.
To send the request, press

Last modified: Sep 01, 2011

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KANS-A-N Calling Card Request Form