Contact Information:
Campus club registration must be completed four weeks before Fall, Spring, or Summer term begins
First Name
*
Last Name
*
School
*
E-mail
*
Phone
*
Campus Club Type
*
Please Select
University
High School
Elementary School
Teacher Association
Start Date
*
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
End Date
*
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Price Range Per Item
*
Please Select
$10
$20
$35+
No Preference
School Colors (1/3)
School Colors (2/3)
School Colors (3/3)
Briefly Describe Campus Club
*
Credit Card Information
Note: Your card will be used to guarantee the value of the items you receive. Your card will not be charged unless items are not returned two weeks after scheduled end date.
Name on Card:
*
Credit Card Type:
*
Please Select
Visa
Mastercard
Discover
Amex
Credit Card #:
*
Security Code:
*
Billing Address:
*
Line 2:
City:
*
State:
*
Zip Code:
*
Necklace Shipping Information
Note: Shipping takes up to two weeks once your credit card has been authorized. Necklaces will be sent to you free of charge and a pre-paid return label will be provided as well.
First Name:
*
Last Name:
*
Shipping Address (No P.O. Boxes):
*
Line 2:
City:
*
State:
*
Zip Code:
*
Special Delievery Instructions:
Agreement:
I hereby understand that I am personally responsible for the full value of all items not returned to UAPO and hereby grant UAPO permission to charge the value of any items not returned to my credit card.
*
I Agree
I Do Not Agree
Submit
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