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Welcome to Willard Haitcock Memberhsip Scholarship
Please fill out and submit this form.
4
Questions
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1
What days of the week do you typically use the Kid Zone/Nursery service?
Monday
Tuesday
Wednesday
Thursday
Friday
I do not use the service
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2
Applicant Information
*
This field is required.
Full Name
Address
Email Address
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3
Are you applying as an individual or as a family?
*
This field is required.
A family membership includes either 2 adults living in the same household, 1 adult and dependent(s) under age 22, or 2 adults and dependent(s) under age 22.
Individual
Family
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4
If applying as a family, please list family members and their ages:
A family membership includes either 2 adults living in the same household, 1 adult and dependent(s) under age 22, or 2 adults and dependent(s) under age 22.
Family Member/Age
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5
How do you think involvement with the YMCA could enhance your life or your family's well-being?
*
This field is required.
Share your Y story - write a personal statement explaining why you or your family could benefit from this scholarship. Include any relevant experiences, challenges overcome, or goals you hope to achieve through YMCA membership.
800 words maximum
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Willard Haithcock Membership Scholarship
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