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Community Connections
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Membership Information
For more information about the Community Connections Club, visit our
website
.
Title
First Name
"First Name" is required.
Last Name
"Last Name" is required.
E-mail
Email
"E-mail" is required.
Confirm Email
"E-mail" confirmed text is required.
Emails do not match!
"E-mail"needs to contain a valid entry.
Your password must have
each of the above components
and be at least 12 characters.
Does Not Pass
Low
Moderate
Secure
Very Secure
Re-type your password.
Re-type your email.
Please verify your input by typing it again.
Passwords do not match!
Emails do not match!
Inputs do not match!
Passwords match!
Emails match!
Inputs match!
*
Note: For all phone numbers, please, enter only numbers. Do not enter dashes, parenthesis, etc.
Phone Area Code:
"Phone Area Code" is required.
Phone Number:
"Phone Number" is required.
Business Phone Area Code:
Business Phone Number:
Cell Phone Number:
If you’re an existing lifetime member mark renewal and enter promo code below.
Please indicate if this is a new membership or if you are renewing your existing membership.
Please indicate if this is a new membership or if you are renewing your existing membership.
New
Renewal
"Please indicate if this is a new membership or if you are renewing your existing membership." is required.
Promotion Code
Membership Levels
Select membership type below: Â Â Â Â Â Â Â Â Â Â Â Â Â Â
Level
Student
$15.00
Senior (65+)
$30.00
General
$40.00
Lifetime Membership
$300.00
"Membership Levels" is required.
comm_conn_membership_designation
CC002F
Check here if you are interested in serving on the Community Connections board.
All Community Connections members will be listed in the annual Community Connections Directory. Please check the appropriate box(es) below if you do not want that specific information listed:
Please check appropriate box.
Please check appropriate box.
Address
Main Phone
Work Phone
Cell Phone
Email
If you would like to make an additional, tax-deductible gift to the UCSC Affiliates Scholarships
for deserving local students,
enter the amount you would like to gift in the box below.
Additional gift amount-UCSC Affiliates Scholarships
$
"Additional gift amount-UCSC Affiliates Scholarships" must be currency.
"Additional gift amount-UCSC Affiliates Scholarships" must be equal to or greater than $5.00.
"Additional gift amount-UCSC Affiliates Scholarships" is too large.
cc_additionalgiftAffiliatesScholarship:
cc_additional_gift_Affiliates - AF004F
If you would like to make an additional, tax-deductible gift to the Rita Olsen Pister Endowed Scholarship for UCSC Re-Entry Students, enter the amount you would like to gift in the box below.
Additional gift amount-Rita Pister Endowment Scholarship
$
"Additional gift amount-Rita Pister Endowment Scholarship" must be currency.
"Additional gift amount-Rita Pister Endowment Scholarship" must be equal to or greater than $5.00.
"Additional gift amount-Rita Pister Endowment Scholarship" is too large.
comm_conn_rita_pister_additional_gift_designation
Rita Pister endowment WC001ENDF
Your generosity will help re-entry students complete their educational goals.
If you would like to gift this membership to another person, click the arrow, on the right side below and enter the information for the person who will receive the gift membership.
You will be asked for your billing address at the time you enter your credit card information. If you want your membership materials to be sent to a different address, click the arrow below, on the right, to enter your mailing address.
Enter Mailing Address
Enter Mailing Address
Mailing Address 1
Mailing Address 2
Mailing Address 3
Mailing City
Mailing State
Mailing Zip
Thank you for your your membership and support of UC Santa Cruz Community Connections. For questions or feedback please contact Clea Hermanson,
chermans@ucsc.edu
(831) 502-8192.
If you would like to provide feedback or make a comment you can do so here.
Your personal and financial information is secure.
View our privacy and other disclosures
here.
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