Request For Financial Assistance Letter
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Business Negocio Name Nombre Please Por favor letters letras Receiving Recepción Assistance Asistencia 15 Financial Letter Carta financiera Ymca
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FINANCIAL ASSISTANCE APPLICATION Today’s Date: Gender (circle one): Male Female Your Name: Date of Birth: Home Address: City, State, Zip: Phone (H): (C): Email: Have you previously applied for a YMCA Scholarship ( ) Yes Are you currently a YMCA member ( ) Yes ( ) No ( ) No If so, when If yes, at which branch Are you currently receiving financial assistance from any other YMCA branch within our Association If yes, which branch: Marital Status (please check one): ( ) Single ( ) Married ( ) Separate/Divorced ( ) Widowed Your Employer’s Name: Your Employer’s Address: Are you employed full time or part time If you are a STUDENT, are you currently enrolled in school Name of School: Spouse’s Name: Date of Birth: Spouse’s Employer’s Name:
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