Forms, Policy And Procedures

Forms, Policy and Procedures

Forms for Cardholders

The form required for all first time cardholders to obtain a BruinCard.

Use this form to sign-up, cancel, or adjust your BruinCard payroll deduction. This convenient feature is perfect for allocating funds to your BruinCard for meals and campus services! Please note deductions are post-tax and you cannot withdraw BruinCard funds unless you separate from the University.

Refund Request

The form required to request to close your BruinCard debit account and request a refund of any remaining balance.

Affidavit of ID Theft and/or Fraudulent Use

For use if someone made unauthorized charges to your BruinCard or where a new account was opened in your name.

Forms for UCLA Departments

Recharge Order Request

Use this online submission process for all non-cash award requests and to deposit money to an existing departmental library card (for UCLA Departments use only).
Step-by step instructions available here for reference.

New Library Copy Card Request

The form for UCLA Departments requesting a NEW Copy BruinCard for use at campus libraries to copy and print for business purposes. See Recharge Order Request above for instructions on how to replenish fund on existing copy card. Information Brokers, please use this form here

Research Participant Payment Request

The form for UCLA Departments requesting to deposit funds on UCLA employee and/or student BruinCards for research participation (human subjects).

Affiliate/Guest Request Form

The form for UCLA departments to request a BruinCard for eligible visiting guests who are not officially registered students or staff members on the University payroll, but who require a BruinCard for access to services. There must be a 3 months minimum UCLA affiliated status for a card to be issued.

Note: The BruinCard Center will be reaching out to campus departments on replacing certain affiliates cards with a new card and number, as ID numbers starting with 009 are being phased out of our system. This is only for affiliates that were issued cards over 1 year ago from 01/01/2014, and are still active. Any recent cards processed within the last year would already have a valid ID number.

Meal Cards Form

The form for bulk meal card orders. Departments hosting a visiting group can purchase limited-use meal cards to be used for a restricted time.

BruinCard Image Request

The policy regarding BruinCard image usage. Ask BruinCard to obtain form.