Public Essay Submission – Kindest Kansas Citian

Student Name*

First Last

Grade*

Age*

Gender

Parent(s) / Guardian(s) Name(s)*

Phone / Parent's Phone*

Student or Parent Email*

Make sure it is a box checked often, this is how the winner will be announced!

Home Address*

Street Address Address Line 2 City State ZIP Code

Nominee's Name*

First Last

Nominee's Email*

Nominee relation (adult friend, coach, babysitter, teacher, etc.)*

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