Join Us Membership is completely free and will give you up-to-date insights on the latest in tobacco control efforts around Kansas and the United States. Connect with public health experts to help prevent tobacco use in your community. Email: TFKCinfo@tobaccofreekansas.org Facebook Twitter Membership Name(Required) First Last Title Home/Business Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Organization PhoneFaxEmail(Required) Applying for:(Required) Individual Membership Organizational Membership Membership type (choose one)Local Health or Tobacco Control Coalition I belong to: Name of organizationI currently receive emails from TFKC.(Required) Yes No Add my e-mail address to the TFKC listserve.(Required) Yes No Home Address Street Address Address Line 2 City ZIP Code Legislative Information: To receive action alerts on state and federal legislative issues, the following information is helpful.Legislative InformationIf known: Legislative District #: Legislative District #:Name of local State Senator: State SenatorIf known: Legislative District #: Legislative District #:State legislators you may know or have contacted: Name of local State Representative: State RepresentativeSign and Submit Policy(Required) I agree to these termsBy signing and submitting this application, I agree to the following: As a TFKC member, I will actively promote and support the Coalition’s mission; network with local partners to share Coalition information; use opportunities to participate in Coalition activities; and serve the Coalition as requested to the best of my ability. I verify that I am not now, nor have I ever been affiliated with or received funding from a tobacco company or representative of a tobacco company.