Not-For-Profit Application

CUSTOMER APPLICATION FOR NOT-FOR-PROFIT ORGANIZATIONS

Your application will be reviewed and you will be notified within 1-3 business days. Upon approval, your login and password will be activated.

To get started, please fill out the Application Form below.
Required Fields are marked with *

Organization's Name:

Login Email:

Login Password:

Organization Type:

503(c)3 Number:

I acknowledge that Not-For-Profit Organizations must provide a 501(c)3 Number and a Tax Exempt Entity Exemption Certificate, if applicable, to avoid sales tax charges. 501(c)3 status does not guarantee eligibility.

Billing Address 1: (No P.O. Boxes Please)

Billing Address 2:

City:

State:

Zip Code:

Ship To Address 1: (No P.O. Boxes Please)

Ship To Address 2:

City:

State:

Zip Code:

Primary Contact Name:

Primary Contact Phone:

Primary Contact Email:

Secondary Contact Name:

Secondary Contact Phone:

Secondary Contact Email:

Please type the letters and numbers below

If you would have any questions, feel free to call our Customer Service at (913) 250-2692

or send an email to KDOC_KCI_Customer_Service@ks.gov

You can also drop us a line using our Contact Us page: Click here

CUSTOMER APPLICATION FOR NOT-FOR-PROFIT ORGANIZATIONS

Call Customer Service at 913-250-2692 or E-mail at: KDOC_KCI_Sales@ks.gov