New/Renewal Membership Application
Calendar Year 2017 / Payment with Visa or MasterCard can be made at http://kappp.org or you can still pay with check. Either way, mail completed application to:
Bonnie Edwards, KAPPP Treasurer
Kansas Department of Administration
900 SW Jackson Suite 451S
Topeka, KS 66612
FEIN: 48-1107850
DO NOT SEND CASH
SMART VENDOR #56069 address #8
· INDIVIDUAL MEMBERSHIP - $25.00
Name and Title Certification and Dates: Issued/Expires
Agency Name
Agency Mailing Address
Phone Fax E-mail
Are you a National NIGP Member? Yes No
New Member Renewal
· ORGANIZATIONAL MEMBERSHIP - $80.00
(Includes up to 4 individuals – Only one vote on Chapter Matters)
Agency Name
Agency Mailing Address
Phone Fax
Individual Name and Title E-mail Certification and Dates: Issued/Expires
Individual Name and Title E-mail Certification and Dates: Issued/Expires
Individual Name and Title E-mail Certification and Dates: Issued/Expires
Individual Name and Title E-mail Certification and Dates: Issued/Expires
Is anyone a National NIGP Member? Yes No
New Member Renewal