Alumni Membership Offer University House is offering UoM Alumni a 12-month membership, subscription-waived! Gain access to Club facilities, Member events, exclusive member offers, and connect with member interest groups. To join, simply complete and forward the application form below. By completing the form, you authorise and consent University Club to collect, use and disclose your personal information for the purposes of processing your application, administering your membership, providing services, and to contact you about other products, discounts and special offers in accordance with the Privacy and Data Protection Act 2014 (Vic). Please note - UoM staff eligible for Full Ordinary membership that are also alumni of the UoM are not eligible for Alumni membership. Any questions please contact us at membership@unihouse.org.au. Your Name TitleProf.A/Prof.DrMsMrsMissMrOther Date of Birth Please fill out this field so that we may issue you with a birthday reward Day12345678910111213141516171819202122232425262728293031 MonthJanFebMarAprMayJunJulAugSeptOctNovDec Year19171918191919201921192219231924192519261927192819291930193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010 Postal Address* Phone Number* Please Specify at least one Office Home Mobile Email Address* Date of Graduation* Faculty that you received this offer from* I confirm that University House will invoice me after my free 1 year membership for the amount of $112.50 to continue my membership.