Membership Application Form

Membership in the University Club is open to USC Faculty, post-docs, eligible Staff and University Affiliates.  

This application is for current USC employees only.  If you would like to apply for an affiliate membership, please click here or for a retired membership, please click here and you will be redirected to the correct page.

*Required Field

*First Name:
*Last Name:
*Email:
*Home Address:
*Home City:
*Home State:
*Home ZIP:
*Home Phone:
*Campus Address
(& Mailing Code):
*Campus Phone
*Academic Rank or Administrative Title:
*Department:
*7 Digit University ID:
*Date of Hire (mm/dd/yyyy):
Payment Frequency:
*Please choose one of the following:
(If you have never been a member of the USC University Club, select "New Member."   If you have been a member in the past and want to reinstate your membership, please select "Reinstatement.")
  New Member
Reinstatement
NOTE: There may be a reinstatement fee of $50 for members who discontinue membership and then rejoin within 3 months. Check with us regarding details.
*Would you like a card for your spouse/partner as well?
 
If yes, please enter your spouse/partner's name:
 

University Club dues of $282 are paid annually using check, Visa, MasterCard or American Express. *Please choose one:

University payroll deduction - dues and meal charges are paid by regular payroll deductions. The University of Southern California is hereby authorized to deduct University Club food and beverage charges and dues from my monthly payroll. The first year of club membership is free for eligible USC employees who are first-time members. Payroll deduction of dues will commence automatically at the end of the first year unless the membership is canceled in writing to the University Club business office.

Paid by departmental requisition - requisitions for dues if paid by your department are due in our business office before the start of each fiscal year. My dues will be paid by USC departmental requisition. I understand that my membership will be automatically renewed annually and be charged to the USC departmental account provided on the original requisition at the beginning of each fiscal year unless the membership is canceled in writing to the University Club business office. (A reminder of this will be sent to members prior to the beginning of each fiscal year to confirm this arrangement, or provide an opportunity to convert the membership dues to be paid by personal payroll deduction.)
Comments:
Verification Number: 6893  (required)