2018 Application Form - UCLA Lake Arrowhead Lodge

If you have any questions regarding your application please contact us at (909) 337-2478.

* Fields marked with an asterisk below are required.

Eligibility*

Select all that apply.

I am a UCLA Alumnus/Alumna
I am a current UCLA Full-Time Faculty
I am a current UCLA Full-Time Staff
I am a current UC Alumnus/Alumna, Staff, or Faculty (eligible for Weeks 9 & 10 only)

Name Used While Attending UCLA*

Degree & Year (or Years Attended)*

Major / School*

UCLA Alumni Membership Number

Expiration Date

Department*

Staff / Faculty ID#*

UC Campus*

Affiliation*

Contact Information

Name*

First Last

Address*

Street City State ZIP Code

Phone*

Mobile Phone

Email*

Bruin Woods Week Preference*

Select the desired Week of attendance, in order of preference.

— First Choice

2018 Bruin Woods Summer Family Camp Dates
Week 1	June 23 – 30	Week 6	July 28 – Aug 4
Week 2	June 30 – July 7	Week 7	Aug 4 – 11
Week 3	July 7 – 14	Week 8	Aug 11 – 18
Week 4	July 14 – 21	Week 9*	Aug 18 – 25
Week 5	July 21 – 28	Week 10*	Aug 25 – Sep 1
*Weeks 9 & 10 are open to all UC system alumni or current staff or faculty from any of the nine affiliated campuses.

2018 Bruin Woods Summer Family Camp Rates
Adult:	$1,477	3 Years – 1st Grade:	$840
6th – 12th Grade:	$1,253	Under 3 Years:	$175
2nd – 5th Grade:	$1,085

— Second Choice

— Third Choice

— List Additional Weeks (if any):

i.e. Week 10, Week 6, Week 9

Guest 1 (Qualifying Applicant — must attend entire week)*

First Name Last Name

Adult / Child 1*

Guest 2

First Name Last Name

Adult / Child 2