2019 MOYAG Scholarship Application
The YMCA Youth and Government program fee is $240. YAG offers financial assistance ranging from $50 to $240. Applications are due by September 18. Applications received after this date will be considered only if funding remains available. If an application is approved, the student’s advisor will be notified of the remaining balance owed to YAG.

Please note that only fully complete applications will be considered.


1. Scholarship recipients and their family must be in need of financial assistance, without which they would not be able to participate in Youth and Government.

2. Applicants should familiarize their advisors with their financial circumstances and inform them that the State Office may contact them for more information.

3. Advisors and students will be notified of a decision by September 26, 2019.

YMCA Youth and Government has limited funds to allocate for financial assistance. The State Office attempts to support as many students as possible with these funds, and to allocate funds in a fair manner. Please be honest with the answers you provide to the questions below to enable us to make informed decisions in the allocation of funds.
Delegation *
If your delegation is not listed, please selected "Delegation Not Listed" and enter it in the text box below.
Delegation Not Listed
If your delegation was not listed, please enter it here
Your answer
Please enter the following information.
First Name *
Your answer
Last Name *
Your answer
Cell Phone
Your answer
Email *
Your answer
Financial Assistant Request *
Please select the amount of financial assistance you are request. Please check all that apply.
Annual Income *
Please enter the current annual income for your household.
Your answer
Size of household *
Please enter the number of children in the household, including the applicant.
1. Why do you want to participate in YMCA Youth and Government? What do you hope to gain from your participation? *
Your answer
2. Why are you requesting financial assistance? *
Your answer
3. Who will be paying the remainder of your program fee – you, parents, others? *
Your answer
4. Is there any other information that the State Office should be aware of regarding your application? *
Your answer
Never submit passwords through Google Forms.
This form was created inside of Missouri State Alliance of YMCAs. Report Abuse - Terms of Service