Thank you for becoming a Member of the Quick Center!
Please proceed below to select your Membership Level.

For questions, please call (203) 254-4010
or e-mail membership@quickcenter.com

Membership Level:

Membership Amount

My/my spouse's employer will match my gift

Employer Name:

How does the Matching Gift program work? Please call the Quick Center Box Office at 203-254-4010 for more information.

Member Information:

Salutation

First Name*

Middle Name

Donor Maiden Name

Last Name*

Donor Suffix

Spouse's Name (if applicable):

I/we wish to be listed in the Quick Center Program Book as:*

Help us celebrate your birthday by sharing your birthdate!

Month

Day

Affiliation with Fairfield University

If you are an alumnus/a or parent, please indicate your/your child's class year

Member Address

Street Address*

City*

State*

Country

Postal Code*

Preferred Email Address*

Confirm Email*

Business Phone*

Other Phone

Payment Information:

Name On Card*

Card Type*

Card Number*

Card Security Code*

Expiration Month*

Expiration Year*

Please check your information carefully for accuracy before continuing with your order.