Financial Assistance Application

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The YMCA of Metropolitan Fort Worth is a non-profit charitable organization committed to helping people grow in spirit, mind and body. We strive to make YMCA programs and membership available to all, regardless of age, ability, background or income. Because of the generosity of our donors, our YMCA scholarship fund is available to reduce the cost of YMCA programs. Please complete the following information to apply for financial assistance:

La YMCA del área Metropolitana de Fort Worth es una organización sin fines de lucro dedicada a ayudar a las personas a crecer en espíritu, mente y cuerpo. Nos esforzamos para que los programas y las membrecías de la YMCA sean disponibles para todos, independientemente de su edad, ingresos, capacidad, raza o antecedentes. Gran parte de los dólares de asistencia financiera que se comparten son posibles gracias a la generosidad de quienes contribuyen a nuestra campaña anual. Por favor complete el siguiente formulario para aplicar para ayuda financiera:

Customer Information

Name*

First Name

Last Name

Address

Address Line 1

City

State

ZIP Code

Date of Birth

Phone

Email*

What programs are you interested in?

Membership/Sports/Swimming Childcare/Afterschool/Day Camp Camp Carter Programs

Other:

Branch/Program Location *

Household Information

Total Number of Adults*

Include all adults living in your household

Total Number of Dependents*

Name of Primary Adult

First Name

Last Name

Name of Second Adult

First Name

Last Name

Name of Third Adult

First Name

Last Name

Name of Fourth Adult

First Name

Last Name

Name of Fifth Adult

First Name

Last Name

Name of First Child

First Name

Last Name

Date of Birth of First Child

Name of Second Child

First Name

Last Name

Date of Birth of Second Child

Name of Third Child

First Name

Last Name

Date of Birth of Third Child

Name of Fourth Child

First Name

Last Name

Date of Birth of Fourth Child

Name of Fifth Child

First Name

Last Name

Date of Birth of Fifth Child

Name of Sixth Child

First Name

Last Name

Date of Birth of Sixth Child

Name of Seventh Child

First Name

Last Name

Date of Birth of Seventh Child

Name of Eighth Child

First Name

Last Name

Date of Birth of Eighth Child

Name of Ninth Child

First Name

Last Name

Date of Birth of Ninth Child

Name of Tenth Child

First Name

Last Name

Date of Birth of Tenth Child

Información del Cliente

Nombre*

First Name

Last Name

Dirección

Address Line 1

City

State

ZIP Code

Número de Teléfono

Fecha de cumpleaños

Correo Electrónico *

¿En cuales programas está interesado/a?

Membrecía/Deportes/Lecciones de natación Cuidado de niños/Día de campo Programas de Camp Carter

Other:

Sucursal/Local del Programa

Información del Hogar

Número completo de Adultos*

Incluye todos los adultos viviendo en casa

Numero completo de Dependientes *

Customer Information

Household Information

Financial Information

Información del Cliente

Información del Hogar

Información financiera