YCares Financial Assistance Calculator

The YMCA strives to make our programs and membership available to all who will benefit from them, regardless of their ability to pay. All financial assistance is granted on a sliding scale based on income and need. All information is kept confidential.

Please fill out the form below to see if a membership scholarship may apply to you. Verification of income will be required to confirm need. We will get back to you for further information on how to complete the application process.

Note: Scholarship percentages calculated on the website may differ from what you are actually eligible. This is used to get the process started and give an idea of what you may be eligible for.

Primary Applicant Information
Name
Date of Birth
Address
City
State
Zip
Email
Cell Phone Number
Employeer
Occupation

Second Adult Applicant Information
Name
Date of Birth
Address
City
State
Zip
Email
Cell Phone Number
Employeer
Occupation

Assistance Request
What kind of membership are you interested in?
 Youth  Adult  Family
 
What programs are you interested in?
 Sports  Aquatics  Enrichment
 After/Before Care  Summer Camp  Other
 

Household Information
How many people are in your household?

Monthly Income Information

Please fill in your monthly income as accurately as possible into the calculator below. If you already know your total monthly income, just put that number in the "other" input box to see your calculation.
Use numbers only. No dollar signs ($), periods (.), commas (,) or letters. Thank you.
Number of Family Members
Monthly Wages, Salaries, Tips for you (before taxes)
Monthly Wages, Salaries, Tips for your Spouse (before taxes)
Monthly Unemployment compensation you receive
Monthly Social Security compensation you receive
Monthly Child Support you receive
Other monthly income you receive
(e.g. Food Stamps, Aid to Dependent Child, 401K, Alimony, etc).

Additional Information
Please inform us of any special circumstance that affects your income Examples; recent unemployment, medical bills etc.

In order to calculate your potential discount correctly, please ensure you used numbers only. No dollar signs ($), periods (.), commas (,) or letters. Thank you.
Monthly Income
Annual Income
Membership Discount (%)
Program Discount (%)

*After submitting this form, we will contact you to verify all of your information, and sign off on it.