A KANS-A-N Authorization Card is required for making long distance telephone calls from off-site stations through the KANS-A-N telephone system. To request a KANS-A-N Authorization Card, please complete the form below and send it to the Networking and Telecommunications Department.

I acknowledge that if a card is issued to me it will enable me to charge long distance telephone calls to the department account number. Only official business calls will be made using this authorized card. (The person that the KANS-A-N card is issued to is responsible for the card. DO NOT SHARE YOUR CARD WITH ANYONE To protect your account from fraudulent abuse.) I will accept full responsibility for all calls charged to this card, and I will return the card to the Networking and Telecommunications Department if I leave the University of Kansas. * indicates required information

*Name:	Name of the person that will be using the cards.
*Department Name:
Department Address:
*Department Phone Number:	--
Account Number:	(PeopleSoft Org + fund or grant number) to be used with this Authorization.
How many cards do you need?