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Student Gamecock Club Application

To join the Student Gamecock Club send in this information and either drop it off at the Roundhouse located on Rosewood Drive or mail it to:

 • Student Gamecock Club Index Page

Social Security #:
School Phone #:
2005-06 School Address:
Permanent Address:
Home Country:
Date of Birth:

Please Enclose Payment of $20 (membership)
Method of Payment: Cash, Check, or Credit Card
Please make checks payable to USC Gamecock Club
Account Number
Expiration Date
*Maker authorizes the bank issuing the Bank Charge card identified on this item to pay this check promises to pay the amount as stated therein to such bank in accordance with agreement governing use of the card.
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