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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.

A Passport Membership rate could start as low as:

  • Adult Membership: $27.65 per month
  • Individual Parent: $33.30 per month
  • Family: $37.80 per month

The examples above show only 3 membership categories of the many we offer, including ROC City Memberships. Rates are subject to change. If determined eligible, Experience Scholarship awards are the lowest rate possible and cannot be lowered.

START YOUR APPLICATION

Have you applied for a membership through our Experience Scholarship Program within the last 6 months?
  • I understand Experience Scholarship assistance and overall rates have changed. 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 within the program’s guidelines. If determined eligible, the rate awarded is non-negotiable.

First-time applications that are complete and current members applying for (or renewing) an Experience Scholarship are of highest priority. An Experience Scholarship must be redeemed within the approved time frame and is valid for one year (12 months) from the date you start your membership.

If:

  • you submitted an application within the last (6) months that was never determined eligible,

  • you were approved within the last (12) months but did not start a membership,

  • you were approved within the last (6) months and started your membership but has since been cancelled for any reason,

 

please first contact our Experience Team at Membership@RochesterYMCA.org who will determine if reapplying is necessary. If our records show any of the above, your application will be reviewed at the discretion of the Experience Scholarship Department based on the number of first-time unprocessed applications and renewal applications we have at that time. A request to change or extend an award does not guarantee approval and is subject to immediate denial at the discretion of the Experience Scholarship Department.

Name
Address
A Passport Membership allows you to access any YMCA of Greater Rochester facility. Your chosen location is where you will be able to set up your membership.
If approved, indicate the type of Experience Scholarship that best fits your needs (If you are requesting a scholarship for camp only, please reach out to that camp site directly):
Indicate if you currently do, or intend to, enroll in any of the following programs available to members only:

Whether or not they will be included on the member and/or participating in a program, provide the name and date of birth (MM/DD/YYYY) for each individual residing at your residence.

Household Member 1
Household Member 2
Household Member 3
Household Member 4
Household Member 5
Household Member 6
Household Member 7
Household Member 8
Household Member 9
Household Member 10
Will you yourself be included on, and using this membership? (Note: Youth Memberships alone do not grant full-facility access. Youth Memberships offer only program access to register for Swim Lessons and Youth Sports, and discounts on Day Camp and Before & After School Care.)

Of the household members provided above, including yourself if applicable, list each member to include on the membership. Please review the membership type selected above. The household members to include should accurately reflect the selected description above

Named Adult 1
Named Adult 2
Named Adult 3
Named Dependent 1
Named Dependent 2
Named Dependent 3
Named Dependent 4
Named Dependent 5
Named Dependent 6
Named Dependent 7
How do you currently pay for housing?
Does anyone in your household receive assistance through SNAP or HEAP?
  • I may be required to provide a copy of my SNAP and/or HEAP benefit letter(s).
  • An application will not be processed if only the front pages are submitted. The application will remain pending until both front and back pages are received. 
  • Anyone listed on my application that is not included in my SNAP and/or HEAP letters is subject to ineligibility.
  • I must include all individuals living in my household and provide accurate income information for each, whether or not they will be included in any membership and/or service I am applying for. 
  • If I do not provide adequate supporting documentation for all household members as stated above, that my application will not be processed.
Provide all income received for each individual in the household, whether or not they will be included in any membership and/or services I am applying for. Include income from all sources that make it possible to pay regular monthly expenses that cannot be paid for with SNAP or HEAP benefits (e.g., housing, transportation, phone, internet, etc.).
Provide all income received for each individual in the household, whether or not they will be included in any membership and/or services I am applying for. Include income from all sources that make it possible to pay regular monthly expenses that cannot be paid for with SNAP or HEAP benefits (e.g., housing, transportation, phone, internet, etc.).
Provide all income received for each individual in the household, whether or not they will be included in any membership and/or services I am applying for. Include income from all sources that make it possible to pay regular monthly expenses that cannot be paid for with SNAP or HEAP benefits (e.g., housing, transportation, phone, internet, etc.).
Indicate all income sources that apply to Income Recipient 4 that makes it possible to pay regular monthly expenses that cannot be paid for using SNAP or HEAP assistance (ie: housing, transportation, phone, internet, etc)
Indicate all income sources that apply to Income Recipient 5 that makes it possible to pay regular monthly expenses that cannot be paid for using SNAP or HEAP assistance (ie: housing, transportation, phone, internet, etc)
Will your membership and/or program be paid for, either partially or in full, by an outside organization (e.g. OPWDD/Self-Direction, County, Agency, Care Manager, etc)?

I have reviewed that all information provided, such as household members, income, address, living arrangements, or other matters which might affect my eligibility, has been fully disclosed and accurate. Changes to a pending or approved application are prohibited and may result in immediate denial of scholarship privileges.