Pay By Mail Membership Application
Please print out and complete this form and mail it with your check to:
Membership
Alumni Association - 1120
UCSB
Santa Barbara, CA 93106-112
 
Your Information
Social Security #
(last 4 digits only)
 __________________

Title

 __________________
First Name _____________________________________________
Middle Name _____________________________________________
Last Name _____________________________________________
Last Name as Student _____________________________________________
Home Address _____________________________________________
City _____________________________________________
State _____________________________________________
Zip _____________________________________________
Home Phone _____________________________________________
Email _____________________________________________
Year of Graduation _____________________________________________


Please Specify Your Primary UCSB Affiliation
____Alumni of UCSB Degree________ Major____________________
____Student of UCSB
____Friend of UCSB

Spouse (Domestic Partner) Information
A free joint membership is available to your spouse/partner if they are a UCSB graduate and reside at the same address.

First Name

 __________________________________________
Middle Name __________________________________________
Last Name __________________________________________
Last Name as a Student __________________________________________
Year of Graduation __________________________________________
Email __________________________________________
 
Membership Type
_____ Supporting Membership (1yr) - $75 - One payment
  _____ Golden Gaucho - $60 (60 years old or over)
  _____ Recent Grad - $60 (within two years)
  _____ Current Student - $60
  _____ Faculty/Staff - $60
_____ Life Membership - $500 - One payment
  _____ Golden Gaucho - $350
  _____Recent Grad - $350
  _____Current Student - $350
  _____Faculty/Staff - $350
_____ Life Membership (installments) - $200/year for 3 years ($600)
  _____Golden Gaucho - $100/year for 4 years ($400)
  _____Recent Grad - $100/year for 4 years ($400)
  _____Current Student - $100/year for 4 years ($400)
 

_____Faculty/Staff - $100/year for 4 years ($400)
  _____Available to all groups - *$19.44/month for 18 months ($350)
   
*Why $19.44? 1944 is the year that UCSB was established, making it the third oldest campus in the UC System behind UC Berkeley and UCLA.
Method of Payment
_____ Check enclosed (Make check out to UCSBAA)
_____ VISA
_____ Mastercard
Credit Card # _________________________________________________________
Exp.______ Signature ________________________________________________