A Continuing Learning Experience
OLLI New Member Registration
To register for OLLI, please fill out the form below. Returning members will be redirected to the CSUF Student Portal to log on using their username and password. For assistance or questions regarding this process please contact Michelle Sanford at 657-278-4270 or
msanford@fullerton.edu
.
Please select one:
New Member
Returning Member / Renewing Member
Member Information:
(All * fields required.)
*
First Name:
Middle Name:
*
Last Name:
Suffix:
Select Suffix
Sr.
Jr.
III
Ph.D.
M.D.
*
Address:
*
City:
*
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylviana
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip:
*
Personal Email:
*
Phone Number: (xxx-xxx-xxxx)
Cell Phone Number: (xxx-xxx-xxxx)
Text urgent OLLI messages to cell phone:
Yes
No
*
Date of Birth: (mm/dd/yyyy)
You must be at least 45 years old to register.
*
Ethnicity:
--- Select One ---
American Indian
Asian
Black
Chicano
Filipino
Other Hispanic
Pacific Islander
White/Caucasian
Unknown
Decline To State
Name to appear on badge: (if different from First name)
*
Gender:
Male
Female
*
Do you need an OLLI Parking pass?
Yes
No
*
License Plate Number:
*
Confirm License Plate Number:
*
Car Color:
*
Car Make:
Abarth
AC
Acura
AIXAM
Alfa Romeo
Alpine
Arash
Ariel
Artega
Ascari
Aston Martin
Audi
AvtoVAZ
BAIC
Bentley
BMW
Borgward
Brilliance
Bristol
Bufori
Bugatti
Buick
Byton
Cadillac
Caterham
Changan
Changhe
Chery
Chevrolet
Chrysler
Citroen
Coda
Dacia
Daewoo
DAF
Daihatsu
Datsun
Dodge
Donkervoort
DS
Ferrari
Fiat
Fisker
Force Motors
Ford
Foton
GAZ
Geely
Genesis
Ginetta
GMC
Great Wall
Haima
Hino
Holden
Honda
Hyundai
Iconic
Infiniti
Isuzu
JAC
Jaguar
Jeep
JMC
Kia
Koenigsegg
Lamborghini
Lancia
Land Rover
Landwind
Lexus
Lifan
Lincoln
Lotus
Luxgen
Magna Steyr
Mahindra
Maserati
Maxus
Maybach
Mazda
Mazzanti
McLaren
Mercedes - Benz
MG
Mini
Mitsubishi
Mitsuoka
Morgan
Morris
NIO
Nissan
Noble
Opel
Pagani
Perodua
Peugeot
Polestar
Pontiac
Porsche
Proton
Ram
Reliant
Renault
Rimac
Rivian
Rolls - Royce
RUF
Saab
Saleen
Saturn
Scion
SEAT
Senova
SIN Cars
Skoda
Smart
Spyker
Ssangyong
Subaru
Suzuki
Tata
Tatra
Tesla
Toyota
Trumpchi
TVR
Vauxhall
Volkswagen
Volvo
W Motors
Wiesmann
Zenos
Zenvo
*
Have you previously had a CSUF student, staff, or faculty account?
Yes
No
The ChroniCLE (OLLI Monthly Newsletter) is delivered via email and copies are available in the office. Additionally, you may request a copy be delivered by US Mail by checking this box.
The annual Blue Book (course catalog) and each semester's OLLI program/class schedule are delivered via email and copies are available in the office. Additionally, to receive these publications by US Mail, check this box.
*
Are you willing to put name/address/phone/email onto an OLLI ride-sharing list?
Yes
No
*
Are you interested in volunteering at OLLI?
Yes
No
*
How did you hear about OLLI that prompted you to join?
Emergency Contact Information:
(All * fields required.)
*
Name:
Address(optional):
City(optional):
Zip(optional):
*
Phone Number: (xxx-xxx-xxxx)
Membership Type:
Membership Type
Select Membership Type
Membership Fee
Total Fee:
I have reviewed the
Committment to Positive Member Experiences, OLLI's Ethical Environment Policy (Policy 2.6) and the CSUF Commitment to Civility
Clear Form Data
