Membership
Become a Member of the University Club!
Membership is open to Faculty, Staff, Alumni, Graduate Students, Emeritus and Retired Faculty and Staff!
All fields marked with a
*
are required and must be completed.
*
Name:
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Type of Membership:
Please select Membership
Faculty
Staff
Alumni
Grad Student
Associate
Emeritus Faculty/Staff
Retired Faculty/Staff
Campus Information
Department:
Campus Address:
Mail Code:
Campus Phone:
Home/Billing Information
*
Home Address:
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City:
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State:
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Zip Code:
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Home Phone:
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Please Enter a Valid Email Address:
Please check if you would prefer not to receive Club information via email.
Please Enter Your Start Date at the University: