Membership Application 2021-2022
Circle K International at UCLA

Welcome to UCLA Circle K International! Circle K International (CKI) is the world's largest collegiate service organization. We offer on and off campus service projects, leadership opportunities, professional development, scholarships, subsidized travel to conferences and conventions around the state and country, and a lifetime of friendships and memories!

Please fill out this application below if you are interested in becoming a member!
Basic Information
First Name *
Last Name *
Are you a new or returning member? *
Birth Date *
Preferred Pronouns *
Are you a transfer student? *
Year *
What is your UID? (University ID number on your Bruincard) *
Contact Information
Phone Number *
Do not add parentheses or hyphens in the number (i.e. 1234567890)
Email Address *
Please put your local address if you will be in the Westwood area.
Street Address and Apt # (or Residence Hall and Room #) *
City *
State *
ZIP Code *
If you live on campus (in the dorms), your zip code is 90024
Additional Information
Emergency Contact *
Please indicate NAME, RELATIONSHIP, and PHONE NUMBER (e.g. Joe Bruin, Mascot, 1234567890)
If living in the Westwood area, do you have a car and are willing to drive?
Drivers are reimbursed for events.
Shirt Size *
How will you pick up your shirt? *
If you need to arrange a meeting to pick up your shirt, please contact the treasurer, Joleen Chiu, through email (, Discord, or Facebook Messenger.
(Optional) If you attended any of our Welcome Weeks events, please list your favorite events:
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy