Kansas Research and Education Network

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Get involved with KanREN

Kansas Research and Education Network Membership Application

Mailing Address Name of Organization
Street Address (ex: 123 Oak Ave)
P.O. Box or Sub-Address (ex: P.O. Box 123)
City
State
Zip

Billing Address (optional) Billing Organization
Street Address (ex: 123 Oak Ave)
P.O. Box or Sub-Address (ex: P.O. Box 123)
Care Of / Attention
City
State
Zip

Getting To Know Your Organization Please describe your organization. Please describe how your organization will use a KanREN connection. Please describe your local and/or wide area network infrastructure that is currently in place. Your Organization's Annual Budget
Your Organization's Staff Size
Number of Networked Computer Systems
Number of Computers in Labs
Number of FTE - Students
Number of FTW - Faculty and Staff

Your New KanREN Connection My organization would like the following sized circuit (please list in megabit per second)
We would like to consult a network engineer regarding our circuit needs.

My organization would like the following amount of Internet capacity (please list in megabit per second)
We would like to consult a network engineer regarding our Internet needs.

Instutitional Contact Information

Institutional Representative Name (ex: John Smith)
Title (ex: Director of Technology)
Telephone Number
Fax Number
Email Address

Network Support Representative Name (ex: John Smith)
Title (ex: Head Network Engineer)
Telephone Number
Fax Number
Email Address

User Services Representative Name (ex: John Smith)
Title (ex: Director of Services)
Telephone Number
Fax Number
Email Address

Library Support Representative Name (ex: John Smith)
Title (ex: Director of Services)
Telephone Number
Fax Number
Email Address