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Chancellor's Club
Membership Levels
Recent Graduate - $250
Blue & Gold Society - $1,500
Anteater Society - $2,500
Daniel G. Aldrich, Jr. Society - $5,000
Founder's Society - $10,000
Lifetime Member - $50,000 (can be paid over 5 years)
Would you like to pay in installments or all at once?
Single Payment
Installments
Membership Automatic Renewal
if checked you would like your membership renewed automatically at the end of your term. This will automatically charge the credit card on file
Automatic Renewal
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Number of Monthly Payments
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Member Information
Salutation
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Mr.
Ms.
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First Name
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Last Name
Relationship to UCI
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Parent
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Payment Recurrence
Page 2
Membership Details
Payments Number
Membership Level Chosen
Total Due
$
Installment Payments (Due Today)
Credit Card Information
Credit Card Number
Credit Card Type
Credit Card Number:
CCFinal
Credit Card Expiration Month
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January
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Credit Card Expiration Year
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Credit Card Security Code
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