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KS Connect Contact Form

Please fill out the below form with your basic contact information for the Kansas Connect program and a member of the PPL team will be in touch with you shortly.

KS Connect Contact Form

Please enter your first name.
Please enter your last name.
Please enter a current/active phone number where we can contact you between 9am and 5pm.
Please enter an email address where we can reach you.
Please tell us in a few words how you heard about this care providing opportunity.