YMCA of Southeastern North Carolina

YMCA Pathways Application

For financial assistance with your YMCA membership, please complete our Pathways Application below or stop by the Welcome Desk at either of our branches to fill out a paper copy.

First Name
Last Name
Email
Address
City
State
Zip
Phone
Date of Birth (mm-dd-yyyy)
Gender
 Female  Male  Prefer not to specify
 
How many dependents (ages 22 and under) are living in your household?
 0  1  2  3  4  5  6 or more
 
How many adults (ages 23 and older) are living in your household?
 1  2  3  4  5  6 or more  
Please tell us your TOTAL monthly household income (please include all household member's incomes)
Please check your YMCA location/area of interest:
 Nir Family YMCA
 Midtown YMCA
 Child Care / Camp Programs
 Ogden YMCA Activity Center
 YMCA Camp Kirkwood
 Youth Sports

Renewal Notice & Agreement

Pathways scholarships must be renewed every six months. You will be notified 30 days in advance of your renewal date informing you to resubmit your application. If you do not renew your Pathways Scholarship application by your renewal date, the discount will be removed and you will be charged the full rate with no refund.

It is your responsibility to update us with phone numbers, mailing address, email address etc. If you fail to update us, you will still be held responsible for fees incurred with no refund

We are committed to serving all people in our community regardless of income. The Y believes a strong sense of ownership and pride are developed when participants contribute to the cost of Y involvement. Therefore, applicants will be asked to pay a portion of their fees. Membership fees are paid annually, semi-annually, or placed on a monthly bank draft. No other payment schedules will be accepted. Program fees will be paid according to the program fee structure. 

I understand that the YMCA of Southeastern North Carolina may ask for income verification at any stage of my membership for auditing purposes.

 By signing, I certify that I have read the above statement and all information is accurate and complete to the best of my knowledge.
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