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University of Wisconsin - La Crosse Alumni Association
Join UW-L Alumni Association Now!
As a member of the UW-L Alumni Association, you'll join the thousands of alumni who want to stay connected to UW-L. Members of the Alumni Association receive many special benefits.

Event Registration

Registrant Information (* = required fields)
First Name *
Last Name *
Maiden Name
Billing Address 1 *
Billing Address 2
City *
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Zip *
Phone *
Fax
Email *
In Case of Emergency
In Case of Emergency Phone Number
Special Accommodations
Graduation Date

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Attending for

Additional Registrants

Payment Information (if applicable)
Total:$20.00
Card Type:
Name on Credit Card:
Credit Card Number:
Expiration Date:
Card Verification Number: What is this?

The Card Verification Number (CVV2 code) is the last 3 digits that are printed on the signature area on the back of your credit card. These 3 digits are not the same as the last 3 digits of your credit card number and they are NOT your PIN or code.

NOTICE: It takes an average of 60 seconds to verify and charge your credit card. Please be patient while this form is submitting. In the event that the form is submitted twice, you will be CHARGED TWICE.

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© 2012 UW-La Crosse Alumni Association | 615 East Ave. N., La Crosse, WI 54601
Ph: 877.UWL.ALUM (877.895.2586) | Fax: 608.785.6868 | Email: alumni@uwlax.edu
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