Financial Assistance Application

The Gaston County Family YMCA is a cause-driven nonprofit organization dedicated to providing affordable programs and services to benefit people of all incomes and backgrounds in our community. The Y helps make children, adults, and families in our communities healthier and more connected in spirit, mind, and body.

The process is simple and confidential. Please complete this form for financial assistance as accurately as possible. All information will be kept confidential. A staff member will review your application and get back with you as soon as possible regarding your application.

This application provides assistance for YMCA Membership and Youth Programs including After School and Summer Day Camp. 

Thanks to the generous support of those who donate to the Y’s Annual Campaign, funding is available to those who cannot afford the full fee and qualify for assistance. Assistance is normally offered at a discount of up to 35% of the full fee for memberships on a need based scale. Y Members are also eligible for financial assistance on Y programs. We allocate many more dollars each year than we fundraise in order to support our community members to the best of our ability.

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Email *
Full Name of Applicant *
Date of Birth *
Person to be billed if other than the applicant *
Phone Number *
Email *
Address *
City *
State *
Zip Code *
What branch are you applying to? *
Are you a foster parent with Gaston County Department of Health and Human Services or Least of These Carolinas?
Documentation from your agency is required.
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The following programs/activities included in this application. Indicate all that you are interested in receiving assistance: *
Required
Would you like more information on receiving assistance for additional Y programs? 
Annual household income before taxes *
If you are a foster family please indicate that here with the word FOSTER
Total number living in the household *
The information I have provided to the Gaston County Family YMCA is true and correct. I understand that I am required to provide my most recent tax forms (front page only) within 15 days of the date of this application. *
How did you hear about YMCA Financial Assistance?
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