Emeriti and Retiree Membership Form

University Recreation

Membership begins on the date activated.

Membership type (required)

Name (required)

Last four digits of WIN (required)

Home address

City

State

ZIP code

Home or cellphone

University department

Email address (required)

Agree to membership contract (required)

I have read and agree to all information in the Student Recreation Center membership contract below.

Enroll in auto renewal?

Please indicate if you would like your membership auto-renewed each year.

University Recreation
Western ��һ�鶹��Ƭ�� University
1903 W ��һ�鶹��Ƭ�� Ave
Kalamazoo MI 49008-5477 USA
Phone (269) 387-4732
Fax (269) 387-3766

Location
2000 Student Recreation Center, Mail Stop 5447