KCS v6 Verified Designation Form

Your Name: (all fields required)

Your Email:

Company:

Address for delivery of KCS v6 Verified certificate:

For the KCS Academy website:
Verified Product Name and Version Number:

Link to the Verified product:

Link to the company logo you'd like displayed:

Description of Verified product (100 words or less):

Select a payment method for the designation fee:
invoicecredit card

Name and contact info of billing contact if different from your info above:

Operations manager Jill DeGraff will be in touch to complete payment.

By submitting this form, you indicate that you have signed and submitted the Verified License Agreement and the Logo Use Agreement to support@thekcsacademy.net. (Opening those agreements in Adobe Reader will allow access to fillable forms.)