Approved Membership Type
Your application WILL NOT BE PROCESSED without the following: A) Most recent year’s Federal Income Tax form (1040 first two pages) B) Four recent paycheck stubs. C) Proof of child support and/or social security benefits. D) Food Stamp or cash assistance determination letter. E) Essay explaining need for scholarship
Applicant Contact Information
List All Household Members to be Included on Membership
List only children who are born to you, legally adopted/guardianed by you, and claimable on your taxes will be considered dependents. Children over the age of 18 are considered a dependent with proof of residence. You may be asked for verification.
Monthly Household Income All Sources
This section must be completed or your application will be considered INCOMPLETE. You may be asked to show documentation.
The YMCA of Greater Erie believes in providing membership and program services to all who desire to participate. The scholarship program, supported in part through donations to the Y’s annual campaign, provides the membership and program service to those in need within our available resources.
PLEASE EXPLAIN, IN DETAIL, YOUR NEED FOR THIS SCHOLARSHIP. YOU MAY ALSO UPLOAD YOUR EXPLANATION AS A SEPERATE DOCUMENT. YOUR APPLICATION WILL NOT BE CONSIDERED WITHOUT WRITTEN EXPLANATION OF YOUR NEED.