* 1. Name of your agency/organization

* 2. Please enter the name (first and last name) of the contact person at your agency/organization who will coordinate your Denim Day efforts.

* 3. Contact's Email Address:

* 4. Contact's phone number:

Thank you for Registering for Kansas Denim Day! Please keep track of how many people in your agency/organization participate in Denim Day. We will contact you after April 23 to ask for this number. Please access the Denim Day materials at www.kdheks.gov/rpe. Contact Laurie Hart at LHart@kdheks.gov or at 785-296-8476 if you have any questions.