Submit a New Application

Submit a Renewal Application

Request a Follow Up

Customer Information

Membership or Program Assistance

Please select the membership type or program subsidy option that best fits your household. When it’s time to activate your members, you will have the option to choose a different membership type based on your Affordable for All pricing. If you are just requesting program only assistance, please select “Program Subsidy Only” in the drop down menu.

Household Information

Sources of household income generally include hourly wages, salaries, unemployment compensation, social security, and retirement or pension income.

Home Branch

Please indicate the Y location you will most frequently visit to help us best process your application. Remember, YMCA members have access to all Y locations in Greater Seattle.

Income Verification Disclosure

Please provide your initials and date of submission to indicate that you have read the following statement:

I acknowledge that this financial assistance award is valid for up to 12 months and I will be subject to periodic income verification. A change to my situation that might impact my ability to receive financial assistance, i.e. a change in employment or income, I agree to bring this to the attention of the YMCA of Greater Seattle. If my reported income cannot be verified or changes, I acknowledge that my financial assistance will be adjusted.

Additional Information