Scholarship Application | Early Learning Centers
The YMCA will provide a Y Experience Scholarship to anyone desiring to participate in our Early Learning Programs, based on established guidelines and to the extent that resources allow. We depend on donations and volunteers to support our services. Anyone is eligible to apply for a scholarship. Awards are made on the basis of demonstrated financial need based on our guidelines. Scholarships are granted for a defined time period, typically 3 to 12 months. Recipients are notified to submit updated information and documentation for review and renewal at least four weeks prior to the financial assistance expiration date. Failure to respond to a renewal notice and complete a review by the expiration date will result in a restoration of standard ELC tuition rates.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of persons living in this household
*
Additional Information for Primary Applicant
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Type of Income
*
Gross Monthly Amount
*
Additional Member of the Household #1
Name
*
First Name
Last Name
Relationship to Primary Applicant
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Income
*
Gross Monthly Amount
*
Additional Member of the Household #2
Name
First Name
Last Name
Relationship to Primary Applicant
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Income
Gross Monthly Amount
Additional Member of the Household #3
Name
First Name
Last Name
Relationship to Primary Applicant
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Income
Gross Monthly Amount
Additional Member of the Household #4
Name
First Name
Last Name
Relationship to Primary Applicant
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Income
Gross Monthly Amount
Additional Member of the Household #5
Name
First Name
Last Name
Relationship to Applicant
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Income
Gross Monthly Amount
Required documentation to upload is last 2 months of bank statements and last 2 months of paystubs for all household members from every employer (if unemployed, current unemployment benefits statement)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Tell Us More
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Continue
Continue
Should be Empty: