Online Registration for: Blue Cross and Blue Shield of Kansas

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After you submit the form you will be redirected to a pay pal site for your deposit payment of $81.00.  (The deposit  covers your last 3 bags and a small administrative fee.)     

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If the name on your paypal account differs from the name on the form please let us know here:

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I understand that I am responsible for picking up my bag each week. I understand the price of each weekly regular bag is $19 (price includes sales tax) and that I will be billed monthly with payment due on the first pickup each following month. I also understand that my membership is not activated until the site coordinator receives my deposit check. I understand the deposits covers the last 3 weeks and a small administrative fee.

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CLICK HERE TO PAY YOUR DEPOSIT

 

SITE COORDINATOR CONTACT INFO:

Pickup location: Blue Cross Blue Shield of Kansas, the west end of the courtyard outside of Bldg. B or in the lobby of Bldg. B for inclement weather