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UIAA Membership Renewal Application

Thank you for your continued support!
Did You Know?You may renew membership in the UI Alumni Association in any of the following ways:

  • Phone
    Call 800/469-2586 (IOWALUM);
  • Mail
    Complete and mail in the printable application;
  • Online
    Complete and submit the form below.

Please be as complete as possible on your name. We ask that you include a middle name as there may be several people with names in common.

Personal Information - Fields marked with an * are required.

*Name
(First, Middle, and Last):

  *E-mail Address:


A valid e-mail address is REQUIRED for submission of this form.

University/Member ID
(if known):

Date of Birth:

Second Member's Name
(if applicable):

Second Member's
University/Member ID (if known):

Second Member's
Date of Birth:
*I live in the United States.
*Street Address:
*City:
*State:
*Zip Code:
*I do not live in the United States.
*Foreign Address:
(Type line by line per postal requirements in your country.)

*Daytime Phone Number

*Membership Options

The Directors' Club Honor Circle and the Old Capitol Club exist for members wanting to contribute over and above their regular dues. This amount is considered a charitable contribution for tax purposes. You will be recognized in the UIAA's and the UI Foundation's annual honor rolls.

$1,000
Directors' Club Honor Circle

$750-999
Old Capitol Club Platinum Membership
Please enter amount of gift:

$500-749
Old Capitol Club Gold Membership
Please enter amount of gift:

$250-499
Old Capitol Club Silver Membership
Please enter amount of gift:

$100-249
Old Capitol Club Bronze Membership
Please enter amount of gift:

    Student membership in IOWA S.T.A.T. (Students Today, Alumni Tomorrow) For currently enrolled UI students only. Join Now!

$25
Recent Graduate membership
(For individuals who have graduated within the last five years)

$45
Regular Annual membership

*All membership levels are considered family memberships unless otherwise requested.

Payment Options
*Please select one payment preference.
 
Credit Card

Use the UIAA
Bank of America
Credit Card
and support the university today!

Apply!

 
  Card Number:
  Expiration Date:

Comments:

Promotion Code
If you have a promotion code, please enter it here.
Code Number:

For Security Purposes
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* You must enter text from the image above.


Please double check your e-mail address. Errors in entering it will delay our receipt of your application.

 


Apply!

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100 Levitt Center, Iowa City, IA 52242-1797
Phone: 319/335-3294 or Toll Free: 800/469-2586
FAX: 319/335-1079;
Copyright © 2009