UCLA Pre-Physician Assistant Club: Membership Application 2026-2027
Thank you for your interest in the UCLA Pre-Physician Assistant Club! We are currently accepting all new and returning members. Please fill out this form so that we have a better understanding of who you are and what you hope to gain out of this club. We are a non-competitive club- we accept all individuals who are interested in joining!

The Membership Fee for the entire academic year is $16 All fees go towards inviting guest speakers and providing resources, transportation, and opportunities for our members. Membership also includes a club t-shirt! The fee is payable by cash to a board member or Zelle/Venmo (please write "Name - Membership").

Zelle: uclaprepa@gmail.com (will be enrolled as Giselle Cortina) 
Venmo: @uclaprepa26

 ***PLEASE DO NOT VENMO WITH TAX! VENMO TRANSACTION SHOULD BE $16 EVEN!***

Feel free to reach out to our email uclaprepa@gmail.com or our Instagram @prepaclubatucla if you have any questions!

Returning Members: A new application and membership fee is required every school year!
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First Name *
Last Name *
Email *
Major *
Year *
What kind of guest speakers are you interested in hearing from? *
Required
What types of resources would you be interested in? *
Required
Why do you want to be a member of the UCLA Pre-Physician Assistant Club? *
Have you Venmo'd $16 to @uclaprepa26 or Zelle'd to uclaprepa@gmail.com?  *
What t-shirt size would you like? (unisex sizing) *
How did you hear about us? *
Required
Are there any previous speakers you'd like to hear from again?
Tell us your favorite songs so we can add them to our club Spotify playlist :D
Anything particular you want to see in the club this year? *
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