Request Financial Assistance for a Program or Membership

Use this form to get started and our staff will walk you through the rest. We only use income information to determine your scholarship opportunity and do not provide this data to any person outside of the YMCA.

After You Submit Your Request

After you complete the form below, a YMCA staff member will reach out to you within 7-10 business days with next steps. We will provide additional information via email or phone call once your request has been processed.

Thank you for reaching out to us and being a part of our Y community!


Customer Information

Please provide the information requested below so that we can provide assistance. All fields are required.

.

Household Income

Sources of household income generally include hourly wages, salaries, unemployment compensation, social security, and retirement or pension income.

.

Scholarship Requested

Please indicate the type of scholarship that you're applying for. After selecting a scholarship type, you'll be asked to provide more information. This information is required.

Program Type
Active Older Adults
Aquatics and Swim
Camp, Overnight or Excursion
Camp, Summer
Child Care
Family Activities
Personal Training
Weight Loss
Youth Enrichment
Youth Sports
.

Home Branch

Please indicate your preferred home branch. If you don't have a preference, select "no preference." Remember, YMCA members have access to all Y locations in Greater Seattle.

.

Income Verification Disclosure

Please provide your initials and date of submission to indicate that you have read the following statement:

I acknowledge that I will be subject to periodic income verification. If my reported income cannot be verified, I acknowledge that my financial assistance may be adjusted.

.
.