Sign In

Gold Shield Annual Membership Dues
(July 1, 2026 - June 30, 2027)


Required fields are indicated with an asterisk (*).
RSVP Information
Membership Type

Please select the one that applies.
SelectDescriptionAmount
Active Membership - $100
Associate Membership - $100
Sustaining Membership - $100
Non-Resident Membership - $50
Sub-Total:
Tax-Deductible:

Grand Total:
Tax-Deductible:
 
Contact Information   

Personal
Title:
* First name:
  Middle name:
* Last name:
  Suffix:
   I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor

Contact Information
* Street:
 
U.S. Addresses  
*   City, State, Zip:
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
  Country:
* This address is my:
* Home telephone:
Business telephone:

* E-mail address:
* This e-mail is my:

Payment
Payment method:
Additional Information
 
Comments: 

     


Find out about the security features of this web page that protect your account information.

For questions about your Gold Shield Membership, contact UCLA Affinity Networks at affinitynetworks@alumni.ucla.edu.
Click here to view privacy policy and disclosure statements to prospective donors.
63034C/M-665


© 2002-2026 UC Regents