Ocean Community YMCA YCares - Financial Assistance Program
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- Dennis Higgins
- 6 years ago
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1 Y scholarships are available to adults, children, and families who are unable to attend the Y or its programs due to inability to pay. A YMCA scholarship is a valuable thing to seek. Because scholarship dollars are limited, applicants are encouraged to pay as much as possible toward the fee. What makes YCares possible? Through proceeds from the Reach Out to Youth Campaign, financial assistance is available for children, adults and families in need. Who can participate? YCares is available to anyone who meets the financial guidelines of the program and has the desire to participate in Y programs and services. What is the philosophy beyond YCares? Ocean Community YMCA s volunteers and staff believe that its programs and services have a positive impact on those who participate and their communities. They believe that these programs and services should be available to everyone who wants to be involved. How can I apply? Complete and return the attached form. Your application will be processed within two weeks and you will receive a notification phone call regarding your subsidy level.
2 The YMCA offers assistance options to ensure that no one is turned away due to financial limitations. Verification of monthly household income is required and must be submitted with this application. You must include at least one of the following items: 1. Most recent year 1040 tax return. 2. Copy of benefits Determination Letters (for Welfare, Free Lunch, SSI). 3. Current, consecutive, pay stubs from the last month. See the YMCA Membership Director with any questions. Additional information may be required in order to determine the appropriate amount of assistance to be awarded (i.e., 3 rd party reference, medical bills, etc.). Funding is made possible for this program through the YMCA Reach Out To Youth Campaign and other contributions. Anyone wishing to contribute to the YMCA should contact their local YMCA Membership Director. Instructions: 1. The participant or parent/guardian must complete the attached financial assistance application. 2. Attach all necessary supporting documents. 3. Sign and return to the YMCA in a sealed envelope addressed to the Membership Director. If all the proper information has been received with a signed application, the YMCA will process the financial assistance request and notify the applicant within two weeks.
3 YMCA Membership Desired (circle applicable category): Adult Young Adult Youth Teen Senior Senior Couple One-Adult Family Two-Adult Family YMCA Programs Applying for: Applicant Name Address City State Zip Phone ( ) Cell ( ) List the name and date of birth for all individuals living in the household who share living expenses (including yourself, spouse, children, etc.) Name DOB Name DOB
4 Monthly Income: Total amount of monthly income before deductions, including wages, salary, public assistance, child support, alimony, social security, unemployment compensation, pension, or retirement income. $ Are you a current member of the YMCA? (circle one) Yes No Why I would like to be a member of the Ocean Community YMCA? Of the full Membership Fee I am willing to pay $ Would you be willing to give a testimonial during our Reach Out To Youth campaign? (circle one) Yes No MUST REDEEM WITHIN 30 DAYS OF RECEIVING THIS AWARD I hereby certify that I have completed all the information requested within this application form, and that all information supplied is true and accurate to the best of my knowledge, and that there is no misrepresentation or omission. I further understand that this application does not constitute acceptance by the YMCA, and that I will be notified as to whether my application for financial assistance has been approved or denied. Date Date Applicant Signature Branch Director or Membership Director
5 FOR OFFICE USE ONLY Percentage Awarded % Date Membership Type or Program Amount F.A. Awarded Due Y Cares Expiration Date: Program % Discount: Notes:
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