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Get Faculty / Staff Dependent Ugacard Application - University Of Georgia

S ages 18-25, page 2 of this application must be completed. Contact UGACard Office for additional requirements for dependents over age 18. Send this form to: UGACard Office 320 Tate Student Center Athens, GA 30602 Last Name: First Name: Social Security Number: Department: Job Title: Dept. Telephone #: Home Telephone #: E-mail address: Sponsor Signature: Date: 1. Dependent's Name (Last, First): Male Female Social Security Number: Date of Birth: (mm/dd/y.

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