OLLI@UGA Gift Membership Form

OLLI@UGA Gift Membership Form

Help someone become a member of OLLI@UGA
Once you have filled out this form, the office will contact you within two business days to advise on methods of payment.

We use this information to set up an account to allow members to register for classes and events.
Your Name

First NameLast Name
Your email
example@example.com
Your Phone Number
Please enter a valid phone number.
How many gift memberships do you want to purchase (for three or more memberships please contact the office directly).
Are you gifting a full membership or a trial membership (only available Mar-April 2022)

Trial MembershipFull Membership
First Recipient Name

First NameLast Name
First Recipient Email
example@example.com
First Recipient Phone Number
Please enter a valid phone number.
First Recipient Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Second Recipient Name

First NameLast Name
Second Recipient Email
example@example.com
Second Recipient Phone Number
Please enter a valid phone number.
Do the two recipients live at the same address

YesNo
Second Recipient Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: