Membership Application Salutation/Title * Name * First Name Last Name Suffix Date of Birth * MM DD YYYY Last 4 of Social Security Number * (This will be your member number) Phone Type * Mobile Work Home Other Phone Number * (###) ### #### Email Address * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Current Employer * Current Job Title Spouse/Partner's Name First Name Last Name How would you prefer to receive your member statement(s)? * Email U.S. Mail Both UofL Affiliation * Faculty Staff Resident Alumnus (you currently live in the Kentuckiana area) Non-Resident Alumnus (you currently live OUTSIDE the Kentuckiana area) Retiree Friend of the University Parent of current UofL Student Membership Type * Alumni, Parent(s) of Current UofL Student(s), & Friends of the University [$50 per month] UofL Faculty, Staff, & Retirees [$30 per month] Non-Resident Alumni [$25 per month] Partial Membership (Lunch Club/Bar Only) Reason for Joining * How did you hear about us? * UofL Today Colleague/Friend/Family Invitation to Lunch or Event by Current Member Social Media Advertisement TV/Radio Online Lunch Were you referred by a current Member? * Yes No Thank you! We will review your application and be in touch soon regarding the status of your membership request! - UClub Membership Department
