The Greensburg YMCA offers quality, affordable
GREENSBURG YMCA FINANCIAL ASSISTANCE POLICY AND PROCEDURES The Greensburg YMCA offers quality, affordable programs and services designed to benefit people of all incomes and backgrounds. The Greensburg Y provides financial assistance as funds are available to individuals and families who otherwise might not be able to participate in YMCA membership or programs. The YMCA’s financial assistance program is made possible through contributions to the organization’s annual Strong Kids campaign. All information submitted is considered confidential and will be seen only by staff administering the financial assistance policy. In no way will anyone receiving assistance be identified publicly without their permission.
Eligibility Financial assistance is provided to applicants who meet criteria established by the Greensburg YMCA. This includes family size, household income, expenses, access to similar services, and extenuating circumstances.
Attached is an application for financial assistance. Please read it completely and enclose all the information needed to process your request for a reduction of fees. Review the checklist to ensure you have included all the necessary documentation when you return the application to the YMCA. Incomplete applications will be returned, which may delay your membership or enrollment in the program. There is great demand for financial assistance, and we try to serve as many individuals and families as possible. For this reason, we seldom fund 100% of anyone’s fees. Once approved your financial assistance lasts a period of 6 months at which time you will be required to reapply do to possible changes in your circumstances. You should expect up to a 30-day processing period on applications for program fee assistance. You will be notified by mail when your financial assistance is awarded. If you have any questions, please do not hesitate to ask for help from the Member Services, Child Care billing or the director of the department in which you are seeking support.
HOW TO APPLY FOR FINANCIAL SCHOLARSHIPS AT THE GREENSBURG YMCA FOLLOW THESE EASY STEPS TO APPLY FOR FINANCIAL SCHOLARSHIPS Completely fill out the scholarship application. Turn in application and provide complete financial verification to the YMCA Member Services desk. Forms of verification: provide two of the following Copy of most recent tax return. Two consecutive paycheck stubs. Most recent W-2. SSI documentation Your application will not be processed until all required verification is submitted in its entirety.
Applications are reviewed on a monthly basis.
Financial Assistance information must be submitted on a 6 month basis, for membership and programs only.
Your application will be kept on file for 90 days and reviewed as funds become available.
An annual increase to the sliding scale will be assessed in July.
Include a brief letter stating why you need financial assistance.
If applying for child care assistance, you must have contacted Child Care Information Services of Westmoreland County and been denied aid.
Greensburg YMCA mission statement: To put Christian principles into practice through programs that build a healthy spirit, mind and body for all.
Greensburg YMCA Youth Development, Healthy Living & Social Responsibilities 101 South Maple Avenue, Greensburg, PA 15601 724-834-0150 www.greensburgymca.org
CONFIDENTIAL SCHOLARSHIP APPLICATION The YMCA is committed to serving people of all ages, races, religions, and economic levels. By answering the following information, you will help to meet this goal. This information is kept confidential and will not be used for any other purpose. Current Date: ________________________
Application:
New
Renewal
Name: _____________________________________________________ Phone No.: ____________________________ Address: _________________________________________ City:______________________ State: _____ Zip: _______ Marital Status:
Married
Divorced
Legally Separated
Widowed
Single
Place of Employment: _____________________________________________ Work No.: _________________________ Spouse/Child(ren)’s Name Age School/Employer Birth date _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Family Size (Total number of members in family) ________ Application is for: Membership
___Youth
___Adult
___College
___Single Parent Family
___Family
___Senior
Program: ____________________________________________________________________________________ Child Care*
___ ECLC ___SACC ___School Age Camp ___Adventure Club ___Counselor-in-Training
Other: ______________________________________________________________________________________ *If this application is for child care, you must have been denied funding through Child Care Information Services of Westmoreland County. Please attach your denial letter with this application. Your application cannot be processed until you submit a denial form. INCOME INFORMATION Wages, Salaries, and Tips $ Unemployment Compensation $ Social Security Compensation $ Child Support $ Food Stamps $ Alimony $ Other $ Total Monthly Income $
Please submit copies of the following documents along with your completed application: 1. Most recently prepared Federal Income Tax return (1040 as well as all schedules and forms 2. Copies of most recent W-2’s, and/or 1099-Rs. 3. Most current paycheck stub. 4. If applicable, current SSI Benefits verification letter or payment stub.
Important: Your application will only be processed when ALL of the required forms have been received. -over-
Please write a paragraph stating why you are requesting financial assistance. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ I am submitting income verification with my application for financial assistance and certify that the above information is true and complete to the best of my knowledge. ___________________________________________________________
________________
Signature of Applicant
Date
Letter sent: ________
Notified ______________
Percentage Used: _________
Office Use Only Name of Applicant: ________________________________________________ Application Reviewed on: _________
Amount: $___________
Denied-Reason: __________________________________________________________
Approved: Date: __________
Eligibility Financial assistance is provided to applicants who meet criteria established by the Greensburg YMCA. This includes family size, household income, expenses, access to similar services, and extenuating circumstances.
Attached is an application for financial assistance. Please read it completely and enclose all the information needed to process your request for a reduction of fees. Review the checklist to ensure you have included all the necessary documentation when you return the application to the YMCA. Incomplete applications will be returned, which may delay your membership or enrollment in the program. There is great demand for financial assistance, and we try to serve as many individuals and families as possible. For this reason, we seldom fund 100% of anyone’s fees. Once approved your financial assistance lasts a period of 6 months at which time you will be required to reapply do to possible changes in your circumstances. You should expect up to a 30-day processing period on applications for program fee assistance. You will be notified by mail when your financial assistance is awarded. If you have any questions, please do not hesitate to ask for help from the Member Services, Child Care billing or the director of the department in which you are seeking support.
HOW TO APPLY FOR FINANCIAL SCHOLARSHIPS AT THE GREENSBURG YMCA FOLLOW THESE EASY STEPS TO APPLY FOR FINANCIAL SCHOLARSHIPS Completely fill out the scholarship application. Turn in application and provide complete financial verification to the YMCA Member Services desk. Forms of verification: provide two of the following Copy of most recent tax return. Two consecutive paycheck stubs. Most recent W-2. SSI documentation Your application will not be processed until all required verification is submitted in its entirety.
Applications are reviewed on a monthly basis.
Financial Assistance information must be submitted on a 6 month basis, for membership and programs only.
Your application will be kept on file for 90 days and reviewed as funds become available.
An annual increase to the sliding scale will be assessed in July.
Include a brief letter stating why you need financial assistance.
If applying for child care assistance, you must have contacted Child Care Information Services of Westmoreland County and been denied aid.
Greensburg YMCA mission statement: To put Christian principles into practice through programs that build a healthy spirit, mind and body for all.
Greensburg YMCA Youth Development, Healthy Living & Social Responsibilities 101 South Maple Avenue, Greensburg, PA 15601 724-834-0150 www.greensburgymca.org
CONFIDENTIAL SCHOLARSHIP APPLICATION The YMCA is committed to serving people of all ages, races, religions, and economic levels. By answering the following information, you will help to meet this goal. This information is kept confidential and will not be used for any other purpose. Current Date: ________________________
Application:
New
Renewal
Name: _____________________________________________________ Phone No.: ____________________________ Address: _________________________________________ City:______________________ State: _____ Zip: _______ Marital Status:
Married
Divorced
Legally Separated
Widowed
Single
Place of Employment: _____________________________________________ Work No.: _________________________ Spouse/Child(ren)’s Name Age School/Employer Birth date _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Family Size (Total number of members in family) ________ Application is for: Membership
___Youth
___Adult
___College
___Single Parent Family
___Family
___Senior
Program: ____________________________________________________________________________________ Child Care*
___ ECLC ___SACC ___School Age Camp ___Adventure Club ___Counselor-in-Training
Other: ______________________________________________________________________________________ *If this application is for child care, you must have been denied funding through Child Care Information Services of Westmoreland County. Please attach your denial letter with this application. Your application cannot be processed until you submit a denial form. INCOME INFORMATION Wages, Salaries, and Tips $ Unemployment Compensation $ Social Security Compensation $ Child Support $ Food Stamps $ Alimony $ Other $ Total Monthly Income $
Please submit copies of the following documents along with your completed application: 1. Most recently prepared Federal Income Tax return (1040 as well as all schedules and forms 2. Copies of most recent W-2’s, and/or 1099-Rs. 3. Most current paycheck stub. 4. If applicable, current SSI Benefits verification letter or payment stub.
Important: Your application will only be processed when ALL of the required forms have been received. -over-
Please write a paragraph stating why you are requesting financial assistance. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ I am submitting income verification with my application for financial assistance and certify that the above information is true and complete to the best of my knowledge. ___________________________________________________________
________________
Signature of Applicant
Date
Letter sent: ________
Notified ______________
Percentage Used: _________
Office Use Only Name of Applicant: ________________________________________________ Application Reviewed on: _________
Amount: $___________
Denied-Reason: __________________________________________________________
Approved: Date: __________
