Name  

UVA ID Number   - (No longer your SSN)

*Deposit
Amount
  ($52 minimum; $1502 maximum per semester)

Phone  

Credit Card Information (for mail-in deposits only):
Account Number:  
Expiration Date:  
Credit Card Issued To:  
Cardholder's Mailing Address:  

Credit Cardholder's Signature ___________________________________________________________



*There is a $2 processing fee per deposit.

Fill out the form on the web, print and sign. Include this with your deposit or mail for credit card transactions.

UVA - Cavalier Advantage
P.O. Box 400313
Charlottesville, VA 22904-4313
Phone: 434-982-5735
Fax: 434-982-5173