Payroll Deduction Form for University Club Membership

The contact person for Indiana University payroll is Debbie Doub: deducts@indiana.edu or 855-6854.

IN ORDER TO ACTIVATE YOUR MEMBERSHIP, PLEASE CONTACT THE UNIVERSITY CLUB AND TELL THEM YOU ARE USING PAYROLL DEDUCTION.  uclub@indiana.edu or 855-1325.

Enter your name:

Enter your street address:

Enter your city                   State                 Zip code


Enter your email address:

A family membership is $80 or a single membership is $60. University Club dues will be deducted from your pay.

Family membership payments will be 6 payments of $13.
A Single membership payments will be 6 payments of $10.

Membership begins in June of each year and ends in May of each year.
Please indicate if you are requesting a family membership or a single membership:

Family Membership ($13 will be deducted from your pay check.)
Single Membership. ($10 will be deducted from your pay check.)

Please enter your IU phone number:

Please enter your Employee ID Number