KPC ID Card
Name:
Last Name First Name MI
Address:
Mailing Address
City State Zip
KPC ID Number
Status: Faculty/Staff - Department:
Student:
Library Barcode #:
For you security: Only your picture, name, library card #, & KPC/UAA assigned
Student ID Number are imprinted on your card.
I certify that the information provided on this document is correct. I have read the
information as stated on the reverse. I understand and accept the terms and condi-
tions as set forth.
__________________________________________ ____________________
Signature Date
For KPC ID Card Office Use Only
Card Holder Identification Verified: __________________Picture ID Type: _______________
Issuers Initials: ____________________________ Issue Date: __________________________
If Remote Image Capture—Image File Name: _______________________________________
Card Holder has elected to participate in UAA WOLF card program by paying the following:
UAA Student Life Fee: $12/credit hr ($144 max) for students registered in 6+ credits.
UAA Student Government Fee: $12 for students registered in 3+ credits
UAA Student Media Fee: $11 for students registered in 3+ credits
Students may elect to pay these fees per semester in order to have access to student organization
programs and services on the University of Alaska Campus. These elective fees may be paid in
the UAA WOLF card office or at the KPC Bookstore.
