Scholarship Application

 In

In addition to your online scholarship application,

Please provide proof of all income:

Food Stamps, Alimony, Social Security, Wages, housing Assistance or other income.

Apply Online

Note: All adults in the household must be working, or claim disability, including full-time college students, in order to receive assistance for the YMCA scholarship program.
Scholarship applications take approximately two weeks to process. Incomplete forms and/or missing documentation will delay processing.
Employer, Phone Number, Hours worked weekly, Hourly Wage, Monthly Income weekly,
Employer, Phone Number, Hours worked weekly, Hourly Wage, Monthly Income weekly,
Employer, Phone Number, Hours worked weekly, Hourly Wage, Monthly Income weekly,
Employer, Phone Number, Hours worked weekly, Hourly Wage, Monthly Income weekly,
Other Sources of Income (If Zero, answer with $0.00)
$200.00, Monthly
VA - $700.00, Monthly / SSI - $300.00, Monthly
Summary of Monthly Expenses
You must provide proof that you are actively pursuing Child Support Enforcement service or you will not qualify for Financial Assistance. The information must be accompanied be the corresponding verification.
Please list monthly amount below
File 1
File 2
File 3
File 4

Fields with (*) are compulsory.

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