LA Fitness: Student Voucher Request Form
Please complete this form if you wish to purchase an LA Fitness Paid-In-Full/Annual/Prepaid membership. If you want to purchase an month-to-month membership you will need to do that via the YouPortal.
College of Dental Medicine
College of Graduate Nursing
College of Health Sciences
College of Health Sciences - Northwest
College of Optometry
College of Osteopathic Medicine
College of Osteopathic Medicine - Northwest
College of Pharmacy
College of Podiatric Medicine
College of Veterinary Medicine
Graduate College of Biomedical Sciences
WesternU E-mail Address
Annual Prepaid Membership You Want to Purchase
Single-Club w/o racquetball $249/year
Single-Club with racquetball $269/year
Single-State w/o racquetball $299/year
Single-State with racquetball $319/year
Multi-State w/o racquetball $329/year
Multi-State with racquetball $349/year
Please read and acknowledge
I may be eligible for the up-to $100 reimbursement from WesternU if I purchase the membership by September 1, 2021 and submit my request to University Student Affairs no later than September 1, 2021.
I understand and will submit my reimbursement request by the deadline.
Do you also want to purchase a membership for a family member?
Up to three family members living in the same household can purchase a membership at the same price.
No thank you
Yes, one family membership
Yes, two family memberships
Yes, three family memberships