You can always press Enter⏎ to continue
hearts
Camp Scholarship Application 
Y Experience Scholarships help remove the financial barriers to accessing YMCA facilities, programs, and services. The scholarship provides individuals and families the opportunity to participate in the life-changing programs and services offered by the YMCA regardless of age, background, ethnicity, ability, or income. 
18Questions
Language
  • English (US)
  • Spanish (Latin America)
  • 1
    Press
    Enter
  • 2
    Press
    Enter
  • 3
    Press
    Enter
  • 4
    Please Select
    • Please Select
    • United States
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
    Press
    Enter
  • 5
    A household is defined as any adult(s) living together with dependents.
    • 0
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6+
    Press
    Enter
  • 6
    Press
    Enter
  • 7
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Option 1
    • Option 2
    • Option 3
    Press
    Enter
  • 8
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Option 1
    • Option 2
    • Option 3
    Press
    Enter
  • 9
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Female
    • Male
    • Prefer not to answer
    Press
    Enter
  • 10
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Female
    • Male
    • Prefer not to answer
    Press
    Enter
  • 11
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Female
    • Male
    • Prefer not to answer
    Press
    Enter
  • 12
    • Spouse/Partner
    • Child/Dependent
    • Child in Foster Care
    • Dependent Adult
    • Other
    • Female
    • Male
    • Prefer not to answer
    Press
    Enter
  • 13
    Please provide all documents that pertain to your household to expedite the process.
    Press
    Enter
  • 14
    You may upload original files or photos of the documents.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.0MB
    Cancelof
    Press
    Enter
  • 15
    Please share any additional information not included on this form, if appropriate. Examples include medical bills, education expenses, and recent changes in employment. Please upload supporting documents on the following page.
    • Huge
    • Large
    • Normal
    • Small
    Ok
    quoteCreated with Sketch.
    Ok
    Press
    Enter
  • 16

    My signature, below, certifies I have read and understand the following: (1) I have provided all requested information that applies to me and my household members. (2) I have provided verification of income of all household members with the most recent two months' pay stubs and/or all other income and bank statements. (3) If I have any dependent children listed, I have provided verification of recent child support payments or verification that I do not receive child support (contact Division of Child Support Enforcement at 253-597-3700). (4) I have provided supporting documentation for the extenuating circumstances described above. (4) I understand this application will be voided 30 days after the review is completed if I do not enroll in a Child Care program at the Y. (5) I understand that the scholarship will expire and the rate will be raised to the full Child Care rate if the review paperwork is not turned in before the expiration date. (6) I understand that scholarships do not apply to drop-in, registration, or late fees.

    I declare the statements above are true and complete to the best of my knowledge. I understand any misrepresentation on my part may disqualify me from receiving a Y Experience Scholarship. I hereby authorize verification of information given, and I agree to provide any and all requested information needed to evaluate my need for financial assistance. I understand a review of my financial situation and circumstances will be periodically conducted at the request of the Y to verify my continuing need for assistance.

    Press
    Enter
  • 17
    Clear
    Press
    Enter
  • 18
    -
    Pick a Date
    Press
    Enter
  • Should be Empty:
Scholarship Application | Camp Seymour/Camp Lake Helena
[Edit]
Question Label
1 of 18See AllGo Back
close