Membership Application Form

Membership Type*

By completing a membership application form, you authorise and consent University Club to collect, use and disclose 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).
Our privacy policy can be viewed at www.unihouse.org.au. Copies are also available at Club Reception.

Please indicate above which membership you are applying for:

New University Staff - one year Full Ordinary (no voting rights) with subscription fee waived.
PhD Candidates - Unrestricted Associate Membership with fee waived for the duration of their research (up to four years).
Full Ordinary Membership - Subscription $395.00 pro rata
Associate Membership (Unrestricted) - Subscription $395.00 pro rata
Associate Membership (Restricted)- $197.50 pro rata (no lunchtime access to the Professors' Walk or UH@W cafés).
Trial Membership - 28 days free subscription to enjoy Club's facilities and events.
Honorary Membership - Visitors/Honorary/Short term - maximum 28 days.

For any membership queries, please call (03) 8344 5254, email
membership@unihouse.org.au or come by Reception at University House, Professors’ Walk.

Your Name

Date of Birth

Please fill out this field so that we may issue you with a birthday reward.

Postal Address*

Phone Number*
Please Specify at least one

Office

Home

Mobile

Email Address *

Campus

Date you commenced working at The University of Melbourne

Staff number

Student number

Date you conclude studies at The University of Melbourne

Department

Job Title

If Part Time, number of hours employed per week

Starting date of Membership

How did you hear about the Club?

Have you visited University House before?

Yes No