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Individual Membership Contribution Form


Individual Membership Information Brochure

General Information
Full Name:
Company Name (if applicable):
Mailing Address:
City, State, Zip:

Home Phone:
Business/Cell Phone:
E-mail Address:
Date of Birth:
Check All That Apply
Alumnus, Class of
Former Blugold Student-Athlete, sport
UWEC Faculty/Staff, dept.
Parent, Son/Daughter, sport
Friend
Blugold Club Individual Membership Levels
Century ($100+)
Varsity ($500+)
Captain ($1000+)
Other, please specify amount:
Payment Selection

Check - Mail to:

BLUGOLD CLUB, UW-Eau Claire Foundation Inc.
214 Schofield Hall, 105 Garfield Avenue
UW-Eau Claire, Eau Claire, WI 54702-4004
Credit Card
If you choose this method, follow the link at the bottom of the confirmation screen after submitting this form. On the Credit Card Donation page, select "Intercollegiate Athletics" under "Gift Information" and also specify the sport.



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