Women's Economic Empowerment Program Application
After you submit this application, we will review your eligibility for the Program. Most women are referred to enroll in a current or future class. We will reach out to you after review to let you know we have received your information. If you qualify, we will again reach out to you during the next open enrollment period to enroll you in an upcoming session. Enrollment typically occurs 2 weeks prior to each class, and class materials are available for pick up the week before class begins.
Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1928
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1921
1920
Year
What County do you currently live in?
*
Please Select
BAY
MIDLAND
SAGINAW
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
E-mail
*
example@example.com
Phone Number
*
Which gender to you most identify with?
*
Please Select
Female
Nonbinary
Transgender Female
Why are you interested in participate in the YWCA Great Lakes Bay Region's Women's Economic Empowerment Program?
*
Please verify below. If you have any difficulties, please call 989-894-9055
*
Submit
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