Membership Application Form

Membership Type*

Please indicate above which membership you are applying for:

Full Ordinary Membership - $385 (for all staff of the University) $193 (PhD candidates: Higher Degree by Research).
Associate/Alumni membership - $385 (for retired staff, alumni and other affiliated persons)
Restricted Associate/Alumni membership (no lunchtime access to the cafés, offered at a reduced rate) - $385
Trial/Honorary – 30 days to enjoy outstanding Club facilities and access to special events on us.

For any membership queries, please call (03) 8344 5254, email
reception@uniclub.com.au or come by reception in person 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

Staff number

Employed by

Name of Dept./Institution (within The University of Melbourne)

Position within Employer’s Institution

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