Affiliate Card Application – OneCard

Carleton retirees (15 years of service, 55 years or older at departure, and benefit eligible)
A Carleton retiree’s spouse/domestic partner
A Carleton employee’s spouse/domestic partner
A Carleton employee’s legal dependents 18 or older living at home
A Carleton retiree’s spouse/domestic partner
A Carleton alum living within 100 miles of the Rec Center
A Carleton alum’s spouse/domestic partner living within 100 miles of the Rec Center

Access to the Recreation Center, Cowling Gymnasium (tennis, lap swim), and West Gymnasium (lap swim)
Schillers (personal funds) deposited for purchases at the Bookstore, Carleton dining halls & cafés, vending machines, copiers, printers, Print and Mail Services
Access to athletic events, concerts, films and other activities (unless the event is limited to students only)

Personal Information

Your Full Name*
Your Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Affiliation with Carleton (chose one)
Please list the name of the Carleton Faculty/Staff member with whom you are affiliated.*
Please list the email of the Carleton Faculty/Staff member with whom you are associated.*
Are you 18-years-old or older?
- Yes
- No
Reason for Request

Consent

Recreation Center Waiver Carleton College Recreation Center Membership Waiver and Release of Liability
I hereby agree to the terms and conditions listed above in the Recreation Center Membership Waiver and Release of Liability.*
- By checking this box I agree to the terms and conditions set out in the Carleton College Recreation Center Membership Waiver and Release of Liability.
Testament of Relationship
By submitting this form you declare you are either: -A spouse or domestic partner of a current Carleton faculty or staff member -A dependent of a current Carleton faculty or staff member over the age of 18 residing in the same location -An Emeriti professor, retiree, or Alumnus in good standing -The spouse or domestic partner of an Emeriti professor, retiree, or Alumnus in good standing You also agree to notify Carleton Human Resources immediately if there are any events that would disqualify you from possessing a Carleton College Affiliate ID Card.

Once the form has been submitted you will be contacted by Carleton within 5 business days.