Membership Enrollment Form

Thank you for your interest in U.Va. Alumni Association membership. Please complete the following form to start or renew your membership. Use our special form to give this membership as a gift.

Credit card information is secured by VeriSign digital encryption. Required fields are marked with an asterisk (*).

Personal Information

*Name:


 
*Address:
 
 
 


 
 

This address is my: Home    Business
School and class:

Membership Type

This is a(n): New Alumni Membership
Annual Membership Renewal
Lifetime Membership Payment
If this is a joint membership, please provide:

 
Lifetime Membership: Individual Life Membership (Paid-in-Full) - $400.00
Individual Life Membership (Installment) - $500.00
    - $50 down; $75 per year for 6 years
Joint Life Membership (Paid-in-Full)† - $450.00
Joint Life Membership (Installment)† - $550.00
    - $50 down; $100 per year for 5 years
Associate Life Membership (Paid-in-Full)†† - $450.00
Associate Life Membership (Installment)†† - $550.00
    - $50 down; $100 per year for 5 years
Add Spouse/Partner to Existing Life Membership† - $50.00
 
Annual Membership: Individual Annual Membership - $35.00
Joint Annual Membership† - $45.00
Associate Annual Membership†† - $40.00
 
Student Membership: Life Membership (Paid-in-Full) - $350.00
Life Membership (Installment) - $450.00
    (Payments deferred until six months after graduation.)
 
Membership Payment: Make a payment on an existing Life Membership
    $
 
Comments:
 
 
 
Note: † Joint membership refers to spouses or domestic partners residing at the same address; spouse or partner is not required to be a graduate.
†† Associate membership refers to any individual who would like to maintain an affiliation with the University who is not a graduate.