EXPERIENCE SCHOLARSHIP APPLICATION

Our Experience Scholarship Program is funded by the generosity of the community and takes every measure possible to forecast funding accurately, ensure that it’s allocated responsibly and that it remains available all year-round. While the Y strives to provide the most thorough consideration of all financial hardship in every application, rates provided are the very best possible within the program’s guidelines. We realize the reduced rate still may not work within everyone’s budgets, or that those previously receiving assistance will see an increase in their monthly rate, however the Y will never offer a rate that is not the best possible award for each application.

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START YOUR APPLICATION

Are you required to apply for financial assistance for a membership through an OPWDD budget (i.e., Self-Direction budget) or other agency?

Yes

If a membership will be paid for by a Third-Party organization (such as an FI through a Self-Direction budget or other agency funding), a simplified form can be submitted through our Third Party Payers page. Our team will invoice your agency’s contact directly (FI, Broker, Care Manager, etc.) at a discounted rate. Once payment is received, a membership can be started immediately. Family members in the same household who would like a family-type membership will have the option to also sign up at a discounted rate. Submit this form here.

PLEASE NOTE: Applications are reviewed as a household on an annual basis. First-time applicants and those renewing an Experience Scholarship are of highest priority. Have you or anyone else within your household applied for an Experience Scholarship within the last 12 months and are NOT current members?

Yes

I understand that if approved, my scholarship is valid for one year and my new membership must be started to be activated. Instructions are provided in the approval letter sent via email.

I understand that if I omit or falsify any information requested, I will not be eligible for assistance now and/or in the future.

I understand that once the verification process has begun, requesting to change information pertaining to my household members, income, or other matters which might affect eligibility, may result in immediate denial.

A NEW APPLICATION IS NOT NECESSARY IF A PREVIOUS SCHOLARSHIP IS STILL VALID. Each scholarship is valid for 12 months from the date of approval. You may start (or restart) your membership for any remaining months of your scholarship at the front desk of the branch shown in your award approval.

If you have a current scholarship membership expiring within the next 30 days, select “No” above to apply for a new 12-month period.

If you or someone in your household submitted an application within the last (6) months and it was not approved, we are unable to accept an application at this time. Please search the inbox (or spam folder) of the email used in your last application by search words “Experience Scholarship” for correspondence from our department regarding your application.

If you need further assistance, email Membership@RochesterYMCA.org.

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