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Secure KANAAE Membership Update Form
Required field |
Information
This form is for
existing KANAAE members
.
Use this form to request changes to your KANAAE membership information, including name, contact information, school information, and/or credit card payment information.
To switch your monthly payments from a credit card to bank draft, change your membership plan, or cancel your membership, please call 1-877-526-2232 (KANAAE2).
If you are interested in joining, renewing, or upgrading your membership, go to the
Join page
.
1. Enter Current Member Information (required)
Fill in as many of these fields as possible to help us find your member record.
Membership Number:
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First Name:
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Last Name:
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Preferred Email:
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2. Select Information to Update (required)
Select all that apply.
Reason(s) for change:
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Change name (fill in green section)
Change mailing address (fill in green section)
Change phone number or email address (fill in green section)
Change school information (fill in yellow section)
Change credit card payment information (fill in red section)
3a. Enter Updated Name/Contact Information
F
ill in only those fields that need to be updated OR fill in all fields.
First Name:
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Middle Name:
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Last Name:
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Preferred Email:
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Preferred Email Type:
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Personal
School
Alternate Email:
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Phone Number:
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Home
Work
Cell
format: xxx-xxx-xxxx
Alternate Phone Number:
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Home
Work
Cell
format: xxx-xxx-xxxx
Mailing Address:
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Mailing Address Apt/Suite:
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City:
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State:
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AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
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HI
ID
IL
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IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AE
AP
Zip Code:
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3b. Enter Updated School/Graduation Information
F
ill in only those fields that need to be updated OR fill in all fields.
School Name:
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School Type:
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Public/Traditional
Public Charter
Virtual
Private/Parochial
College/University
Other (fill in box)
Other:
School District:
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School County:
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School State:
Kansas
Position:
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Grades:
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Subjects:
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College of Education:
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Expected Graduation Date:
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3c. Enter Updated Payment Information
If you are making changes to your payment type, all fields are required
.
Card Type:
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Visa
MasterCard
American Express
Discover
Name on Card:
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Credit Card Number:
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Card Expiration Date:
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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
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2032
Reason for update:
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alerted that my card was declined
alerted that my card is about to expire/has expired
switching card/proactively updating card
4. Review Changes and Submit Request (required)
Enter any additional information below. Please click submit button only once.
Additional Information:
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Interested in getting
more involved?
check all that apply
Recruiting Members
Marketing/Public Relations
Professional Learning Ideas
Association Leadership
Legislative Advocacy
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3c. Enter Updated Payment Information
If you are making changes to your payment type, all fields are required
.