Lehigh Valley Community Rowing Scholarships

HomeLehigh Valley Community Rowing Scholarships

Thank you for your interest in Lehigh Valley Community Rowing. Please complete the questions below to request a scholarship. Please reach out with any questions to (610) 871-5060 or info@ywcaallentown.org.

Adult Rowing Series Scholarship Request

Adult Rowing Series
Spring/Summer 2023
I am interested in
- Spring: Adults (4/4/23 - 5/25/23)
- Summer: Adults (6/13/23 - 7/27/23)
Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
What is the best way to contact you?*
- Email
- Text
- Phone Call
What is your date of birth?*
MM slash DD slash YYYY
What is your preferred language of instruction?*
With which race/ethnicity do you identify? (Select all that apply)*
- African American or Black
- American Indian or Alaska Native
- Asian American or Asian
- Hispanic or Latinx/o/a
- Middle Eastern or North African
- Pacific Islander
- White or European
- Decline to state
We realize that the racial/ethnic category you selected encompasses many different nationalities. If you are interested in sharing more, please describe your nationality (i.e., Armenian, Puerto Rican, Vietnamese):
With which gender do you identify?*
- Woman
- Man
- Agender
- Transgender
- Non-binary
- Gender queer or non-conforming
- An identity not listed
- Decline to state
What are your preferred pronouns?*
- She/Her
- He/His
- They/Their
- Other
How did you hear about this opportunity?*
Please tell us why you are interested in the sport of rowing*
Do you identify as a veteran or active member of the U.S. Armed Forces, Reserves, or National Guard?*
- Yes, Active Duty
- Yes, Veteran
- No
- Decline to state
Have you been diagnosed with any disability or impairment?*
- Yes
- No
- Decline to state
If yes, what (if any) accommodations can we provide for you to be able to fully participate in this program?
Are you currently employed? *
- Yes
- No
If currently employed, please indicate your status:
- Full Time
- Part Time
- Temporary
- Permanent
- Internship
- Apprenticeship
What is the total number of people living in your household?*
Please enter a number greater than or equal to 0.
Please indicate your family's gross income for the most recent tax year: **
- Less than $20,000
- $20,000 - $29,999
- $30,000 - $39,999
- $40,000 - $49,999
- $50,000 - $59,999
- $60,000 - $69,999
- $70,000 or more
Can you think of any reason that you would not be able to participate fully in this program?
Which type of scholarship are you interested in? Please select all that apply.
- Full scholarship: 100% of registration costs ($250 per session)
- Half scholarship: 50% of registration costs ($125 per session)

609 West Hamilton Street, Suite LL200, Allentown, PA 18101 | Phone: (610) 871-5060 | Fax: (610) 871-5061 | EIN 23-1352605 | info@ywcaallentown.org

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