Ohio Y Leadership Conference

Request for Scholarship Funds

Please read the following information carefully BEFORE applying for scholarship funds.

  1. Conversation: YMCA staff member or volunteer has a conversation with his or her Executive Director/CEO/ Direct Supervisor in regards to professional staff or volunteer development and identifies the need for additional training and or skill sets that will further the individuals skill sets and professional development.
  1. CEO Approval: YMCA staff member or volunteer requests and gets approval to register for training and or conference from his or her CEO.
  1. Request: YMCA CEO or supervisor identifies the amount of funds that the YMCA will pay and the amount of financial assistance needed.

APPLICATION—requests for funds must be submitted no later than 30 daysprior to the event.

  1. Submit: A staff member or volunteer can request fundsby submitting an application to:

Ruth Knous

YMCA of the USA

1917 Kingsbury Drive

St. Marys, OH 45885

312-502-3634

emailed to

  1. Scholarship Review: YMCA of the USA Resource Director receives the request; processes the requestbased on need and prepares the acceptance and/or denial letter tothe YMCA staff member or volunteer.Note: a maximum of 1 staff person and 1 volunteer may be eligible for financial assistance from each Y. A limited number of awards are available.
  1. Letter is sent via email to the requestor and copied to the YMCA’s CEO and or supervisor.
  1. Register: Register for conference using the scholarship code the Resource Director will provide to the recipient to be used when registering.
  1. Attend: The YMCA staff member or volunteer attends the training or conference.

Ohio Y Leadership Conference

Scholarship Request

Incomplete requests will not be considered.

Applicant’s Name:

YMCA:
Four Digit Association Number:
YMCA Address:
City, State Zip:
YMCA Telephone:
YMCA Fax:
E-mail:
YMCA Employee Status: / Select OneFull TimePart TimeVolunteer

Is this application for a staff or volunteer? staff volunteer

Please list staff/volunteer:

Please indicate the reason(s) for which you are requesting financial assistance.

Please provide a statement on how the requested assistance will help you/volunteer reach your/volunteer professional development and career goals.

Please provide a statement of how the requested financial assistance will help you and or your YMCA meet the goal of providing high-quality services for your community.

Registration fee(s): Individual $ 179 Individual & Volunteer $ x = $

The conference only provides scholarship funds for registration ($179 or $149) and does not provide funds for travel or lodging expenses.

Please enter amount requested for financial assistance:$

Check box if your YMCA is paying a portion of the registration fee

If yes, please list the amount your YMCA will be paying:$

Other than CEOs—please identify your supervisor

Name

Position:

YMCA:

Address:

City, State, Zip:

Phone:

Email:

Pledge:

Check box if you agree to the following statement:I acknowledge that my CEO or supervisor is awareof my application for scholarship funds.

Please submit request by email only: