Rome YMCA Arsenal Soccer Financial Assistance Application

The Rome YMCA and the Arsenal Rome Soccer Program provides assistance every year to families in our community so that players of all ages may enjoy the game. Please complete this financial aid application to see if you qualify for financial assistance.

This application for financial assistance is for Academy and Select families only. 

Once your Application for Financial Assistance is submitted, you will receive a confirmation email from the Rome YMCA. Please also email an electronic copy of the first two pages of your most recent Federal Income Tax Return and other income documentation to Lucas Levesque. Applications cannot be processed unless supporting documentation is provided to the Rome YMCA. All applications must be submitted using this electronic form. 

For questions regarding this application or Financial Assistance for the YMCA Arsenal Rome Soccer Program, please contact our Director of Coaching, Lucas Levesque at llevesque@ymcarome.org.

First Name
Last Name
Home Address
City, State & Zip Code (no commas)
Email
Phone
Spouse's Full Name
How many children do you have?
Have you received financial assistance from the Rome YMCA in the past?
 

Monthly Income Information

Please fill in your monthly income as accurately as possible into the calculator below. 

Use numbers only. No dollar signs ($), periods (.), commas (,) or letters. Thank you.
Number of Family Members
Monthly Wages, Salaries, Tips for you (before taxes)
Monthly Wages, Salaries, Tips for your Spouse (before taxes)
Monthly Unemployment compensation you receive
Monthly Social Security compensation you receive
Monthly Child Support you receive
Other monthly income you receive
(e.g. Food Stamps, Aid to Dependent Child, 401K, Alimony, etc).

Additional Information

Please inform us of any special circumstance that affects your income examples; recent unemployment, medical bills etc.

In order to calculate your potential discount correctly, please ensure you used numbers only. No dollar signs ($), periods (.), commas (,) or letters. Thank you.

Monthly Income
Annual Income
Soccer Discount (%)