Scholarship Application Form

The YMCA of the Capital Area offers financial assistance for membership and programs to qualified members. We are community based and believe that our programs should be available to everyone and that no one should be turned away because of their inability to pay. Our Financial Assistance Program is made possible because caring people and businesses in our communities fund the program through our Annual Campaign. Financial Assistance is available on a sliding scale that is based on family size and household income.


It’s easy to apply:

1.Please choose the membership and/or all programs for which you would like financial assistance.


2.Complete the application, including name and contact details, household members, and itemized income information. 


3.A copy of your most recent Internal Revenue Service tax statement (tax return) and the last three pay stubs of all working adults must be included to process the application. Your SSI Allocation statement and any unemployment documents (if applicable) must also be included. Include any other documentation that supports your current income. (This information will be held confidential). Students enrolled in college must provide a copy of their most recent FAFSA application and college admissions verification.


4.If you need assistance completing the application, please work with our Member Service Team.



 

Please provide the following monthly finacial information for the entire household: 

Please provide information and any special circumstances as to why you are in need of financial assistance. 

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