The University Club of Nashville 2402 Garland Avenue Nashville, TN 37212
Phone: 615-322-8564
Email: clubnash@comcast.net
Account ____________
MEMBERSHIP APPLICATION
MEMBER INFORMATION (Person responsible for payment of membership charges & fees)

Last Name: First Name: Middle Name:

Spouse/Partner Name:

Date of Birth:

Home Address: City: State: Zip:

E-mail: Home Phone: Cell:

Faculty Staff Alumni
Academic Rank: Position/Title: Year(s)/Graduated:
Department: Department: Degree(s) Earned:

University/College Affiliation :

Business Name/Dept.: Official Title:

Business Address: City: State: Zip:

Business Phone: Fax:

Work E-mail: Assistant:

REGULAR (Faculty, Exempt Staff, Professional Staff or Graduates)

Initiation fee: $50; dues: $30 per month, $360 annually.

ASSOCIATE (Individual serving in a significant capacity with a Member Institution, university and community leaders, elected officials, judges of courts of records).

Initiation fee: $100; dues: $60 per month, $720 annually.

NON-RESIDENT REGULAR (Individuals whose primary residence is outside Davidson County,TN, and its contiguous counties)

Initiation fee: $50; dues: $15 per month, $180 annually.

NON-RESIDENT ASSOCIATE Initiation fee: $100; dues: $30 per month; $360 annually.

SENIOR STATUS (Members who are age 65 and older. Must be a Regular or Associate member for one year.)

Dues: $20 per month, $240 annually.

Initiation Fees: $ Dues: $ *Dues are subject to TN tax

Prefer to pay dues: Send statements/newlsetters to my:

Individuals who are authorized to charge to my account:

If elected to membership, I agree to conform to all requirements of the University Club of Nashville as stated in the by-laws and house rules.

Applicant Signature:___________________________________________________Date:________________________

Complete application in full and fax to: 615-343-6097 or mail to: 2402 Garland Ave., Nashville, TN 37212

MasterCard and Visa gladly accepted.

Member Institutions include all accredited institutions of higher learning in Middle Tennessee that grant baccalaureate or post-graduate degrees. Regular Membership shall also be open to the members of the Board of Regents of the State of Tennessee and to the members of the Tennessee Higher Education Commission. Where doubts arise as to the eligibility of any applicant, the Club Membership Committee shall consider such cases and make recommendations to the Board of Directors, which shall have the final approval.