Payroll Deduction

*IMPORTANT - ACTION REQUIRED FOR MEMBERSHIP ACTIVATION*
 
After completion of this form, your membership will not be active until you finish the in-person portion of your registration: updating your membership profile including photo, activation of campus ID for facility access, and payment of up-front fees (2-months pro-rated)
 
 
If you are adding services/family members to an existing membership, the final calculation for the monthly deduction needs to equal your total deduction including your existing membership(s) as well as any add-ons.  Please choose all the options that will indicate your total family membership package/deduction.
Primary Deduction Authorization Type: Please choose the option for your total complete membership package. *
Do you want to pay for additional family members with your payroll deduction? (must be 18+, immediate family only) *
Number of additional family members to pay with deduction? *

Primary Member Information

Employee Payday Frequency *
Vice Chancellor Area *
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We are sorry to see you go. Please share the reason/s you are cancelling your membership
 
Sign below to cancel your Recreation Membership and click next to complete your request. If you have any questions, call our service desk at (858) 534-3557 or email to recreation@ucsd.edu. *
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