ACCESS Online Application

The Y is committed to ensuring all people can access the services they need at the Y.

The application for ACCESS Financial Assistance applies to aquatics, sports, enrichment, and health and wellness classes at the Demakes Family YMCA in Lynn. You can apply by completing the form below, and a member of our team will be in touch with you about a scholarship amount. If you have additional questions about enrolling in programs, please contact us, and a member of the Demakes Family YMCA team will be in touch with you shortly.

ACCESS Online Application

Online submission to apply for Program Financial Assistance at the Demakes Family YMCA.

Name*

First

Last
Service Area City? Program ACCESS is available to people in our service area only. You must reside in one of the following cities to be eligible for financial assistance. Choose your city:*
Address*

Street Address

City

State / Province / Region

ZIP / Postal Code
Phone*
Email*
Date of Birth for Primary Applicant*

MM slash DD slash YYYY
Total Number of Adults in Household (including applicant)*
Total Number of Children in Household?*
I acknowledge these apply to the Demakes Family YMCA programs.*
- Yes
Please check all that apply.
Secondary Parent/Guardian (if applicable)

First

Last
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Phone
Email
Date of Birth

MM slash DD slash YYYY
Participant 1*

First

Last
Date of Birth (1)*

MM slash DD slash YYYY
Participant 2

First

Last
Date of Birth (2)

MM slash DD slash YYYY

Family membership can include children in your immediate household under the age of 26.
Participant 3

First

Last
Date of Birth (3)

MM slash DD slash YYYY
Household Income*

Please select the bracket that represents your annual household income for all adults in your household.
Would you be interested in applying for a family membership?

Please select one.
Are you interested in aquatics, youth sports and enrichment, and health and wellness classes at the Y?
- YES
Please provide any additional information that we can use to assess your application.
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