GE89-Request for KHSAA Identification

Name of Person to Receive Card:*
Role or Position of the person being issued the Card-*
Describe what role this person plays
Business, Region or School*
This could be a company, a Region or Regional Officials Association, School or other entity
Address to mail card (will be mailed directly to ID holder)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Person Making Request*
Email of Person Making Request*
Enter Email Confirm Email
Head/Shoulders Picture*
Upload head and shoulders picture
Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.