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href="https://kishymca.org/youth-roller-hockey/">Youth Roller Hockey League</a></li> </ul> </li> <li id="menu-item-10150" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10150"><a href="#">Teen Programs</a> <ul class="sub-menu"> <li id="menu-item-10151" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10151"><a href="https://kishymca.org/know-your-y-for-teens/">Know Your “Y” for Teens</a></li> </ul> </li> <li id="menu-item-9911" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-9911"><a href="#">Adult Sport Programs</a> <ul class="sub-menu"> <li id="menu-item-11219" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11219"><a href="https://kishymca.org/private-tennis-lessons/">Private Tennis & Pickleball Lessons</a></li> <li id="menu-item-9926" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-9926"><a href="https://kishymca.org/pickleball/">Pickleball</a></li> <li id="menu-item-11208" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11208"><a href="https://kishymca.org/adult-pick-up-basketball-program/">Adult Pick-Up Basketball Program</a></li> <li id="menu-item-11212" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11212"><a href="https://kishymca.org/self-defense-class/">Self Defense Class</a></li> <li id="menu-item-10765" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10765"><a href="https://kishymca.org/martial-arts-for-seniors/">Martial Arts</a></li> <li id="menu-item-8814" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8814"><a href="https://kishymca.org/tai-chi/">Tai Chi</a></li> </ul> </li> <li id="menu-item-9912" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-9912"><a href="#">Adult Sport Leagues</a> <ul class="sub-menu"> <li id="menu-item-10938" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10938"><a href="https://kishymca.org/adult-roller-hockey-league/">Adult Roller Hockey League</a></li> <li id="menu-item-11001" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11001"><a href="https://kishymca.org/co-ed-volleyball-league/">CO-ED Adult Volleyball League</a></li> </ul> </li> </ul> </li> <li id="menu-item-9897" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-9897"><a href="#">Aquatics</a> <ul class="sub-menu"> <li id="menu-item-10084" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10084"><a href="#">Swim</a> <ul class="sub-menu"> <li id="menu-item-11220" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11220"><a href="https://kishymca.org/swim-lessons/">Swim Lessons</a></li> <li id="menu-item-10079" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10079"><a href="https://kishymca.org/private-swim-lessons/">Private Swim Lessons</a></li> </ul> </li> <li id="menu-item-10462" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-10462"><a href="https://kishymca.org/dekalb-county-swim-team-dcst/">Dekalb County Swim Team (DCST)</a> <ul class="sub-menu"> <li id="menu-item-10104" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10104"><a href="https://kishymca.org/dcst-private-swim-lessons/">DCST Private Swim Lessons</a></li> </ul> </li> </ul> </li> <li id="menu-item-328" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-328"><a href="#">Healthy Living</a> <ul class="sub-menu"> <li id="menu-item-238" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-238"><a href="#">Exercise Classes</a> <ul class="sub-menu"> <li id="menu-item-11206" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11206"><a href="https://kishymca.org/waterexerciseclasses/">Water Exercise Classes</a></li> <li id="menu-item-8829" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8829"><a href="https://kishymca.org/functional-training-classes/">Functional Training Classes</a></li> <li id="menu-item-3837" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-3837"><a href="https://kishymca.org/pedaling-for-parkinsons/">Pedaling for Parkinson’s</a></li> <li id="menu-item-11207" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11207"><a href="https://kishymca.org/prenatal-strength-birth-prep/">Prenatal Strength & Birth Prep</a></li> <li id="menu-item-9960" class="menu-item menu-item-type-post_type menu-item-object-post menu-item-9960"><a href="https://kishymca.org/project-phoenix/">Project Phoenix</a></li> </ul> </li> <li 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class="menu-item menu-item-type-post_type menu-item-object-gt3_gallery menu-item-7509"><a href="https://kishymca.org/gt3_gallery/kishwaukee-family-ymca-photo-gallery/">Facility Photo Gallery</a></li> </ul> </li> </ul> </li> <li id="menu-item-65" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-65"><a href="https://kishymca.org/schedules/">Schedules</a></li> <li id="menu-item-9913" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-9913"><a href="#">Events</a> <ul class="sub-menu"> <li id="menu-item-11230" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11230"><a href="https://kishymca.org/2025-third-annual-art-contest/">2025 Third Annual Art Contest</a></li> <li id="menu-item-10936" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10936"><a href="https://kishymca.org/family-fun-nights/">Family Fun Nights</a></li> <li id="menu-item-11210" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11210"><a href="https://kishymca.org/aquatics-easter-egg-hunt-roller-skating-night/">Aquatics Easter Egg Hunt & Roller Skating Night</a></li> <li id="menu-item-9594" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-9594"><a href="https://kishymca.org/lunch-learn-series-with-northern-rehab/">Lunch & Learn – Series with Northern Rehab and Hy-Vee</a></li> </ul> </li> <li id="menu-item-192" class="menu-item menu-item-type-custom menu-item-object-custom current-menu-ancestor current-menu-parent menu-item-has-children menu-item-192"><a href="#">Membership</a> <ul class="sub-menu"> <li id="menu-item-1057" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-1057"><a href="https://kishymca.org/benefits-membership/">Benefits of Membership</a></li> <li id="menu-item-195" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-195"><a href="https://kishymca.org/join-the-y/">Join the Y</a></li> <li id="menu-item-194" class="menu-item menu-item-type-post_type menu-item-object-page current-menu-item page_item page-item-168 current_page_item menu-item-194"><a href="https://kishymca.org/open-doors/" aria-current="page">Open Doors Financial Aid</a></li> <li id="menu-item-193" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-193"><a href="https://kishymca.org/corporate-membership/">Corporate Membership</a></li> <li id="menu-item-4698" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-4698"><a href="https://kishymca.org/nationwide-ymca-membership/">Nationwide YMCA Membership</a></li> <li id="menu-item-196" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-196"><a href="https://kishymca.org/policies/">Policies</a></li> <li id="menu-item-8158" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8158"><a href="https://kishymca.org/facility-usage-requirements/">Facility Usage Requirements</a></li> </ul> </li> <li id="menu-item-197" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-197"><a href="#">Work for the Y</a> <ul class="sub-menu"> <li id="menu-item-11265" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11265"><a href="https://kishymca.org/online-employment-application/">Employment/Volunteer Application</a></li> <li id="menu-item-11264" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-11264"><a href="https://kishymca.org/2025-summer-camp-now-hiring/">2025 Summer Camp: NOW HIRING</a></li> <li id="menu-item-199" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-199"><a href="https://kishymca.org/why-work-for-the-y/">Why Work for the Y</a></li> </ul> </li> <li id="menu-item-200" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-200"><a href="#">Donate</a> <ul class="sub-menu"> <li id="menu-item-201" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-201"><a href="https://kishymca.org/donate/">Donate</a> <ul class="sub-menu"> <li id="menu-item-7654" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-7654"><a href="https://kishymca.org/donor-privacy-policy/">Donor Privacy Policy</a></li> </ul> </li> <li id="menu-item-608" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-608"><a href="https://kishymca.org/y-stories/">Y Stories</a></li> <li id="menu-item-203" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-203"><a href="https://kishymca.org/volunteer/">Volunteer</a></li> </ul> </li> <li id="menu-item-463" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-463"><a href="https://kishymca.org/contact-us/">Contact Us</a></li> </ul></div> </div> <div class="select-menu"> <select class="the-selectors" onChange="document.location.href=this.options[this.selectedIndex].value;"> <option value="">Navigation</option> <option value="https://kishymca.org/">Home</option><option value="#">Our Cause»</option><option value="https://kishymca.org/mission-history/">- Mission & History</option><option value="#">- Social Responsibility»</option><option value="#">- Social Services»</option><option value="https://kishymca.org/open-doors/">- Open Doors Financial Aid</option><option value="https://kishymca.org/volunteer/">- Volunteer</option><option value="https://kishymca.org/donate/">- Giving</option><option value="https://kishymca.org/ymca-stories/">- YMCA Success Stories</option><option value="https://kishymca.org/share-your-story/">- Share Your Y Story</option><option value="https://kishymca.org/board-of-directors/">- Board of Directors</option><option value="https://kishymca.org/annual-report/">- Annual Report</option><option 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value="https://kishymca.org/bethfowlerschoolofdance/">- Beth Fowler School of Dance</option><option value="https://kishymca.org/jr-roller-derby/">- Jr. Roller Derby</option><option value="https://kishymca.org/karate/">- Karate & Martial Arts</option><option value="https://kishymca.org/dekalb-county-gazelles/">- DeKalb County Gazelles</option><option value="https://kishymca.org/fit-for-life-homeschool-youth-pe/">- Fit for Life – Homeschool Youth PE</option><option value="#">- Youth Sport Leagues»</option><option value="https://kishymca.org/youth-basketball-leagues/">- Youth Basketball League</option><option value="https://kishymca.org/youth-indoor-soccer-league/">- Youth Indoor Soccer League</option><option value="https://kishymca.org/youth-roller-hockey/">- Youth Roller Hockey League</option><option value="#">- Teen Programs»</option><option value="https://kishymca.org/know-your-y-for-teens/">- Know Your “Y” for Teens</option><option value="#">- Adult Sport Programs»</option><option value="https://kishymca.org/private-tennis-lessons/">- Private Tennis & Pickleball Lessons</option><option value="https://kishymca.org/pickleball/">- Pickleball</option><option value="https://kishymca.org/adult-pick-up-basketball-program/">- Adult Pick-Up Basketball Program</option><option value="https://kishymca.org/self-defense-class/">- Self Defense Class</option><option value="https://kishymca.org/martial-arts-for-seniors/">- Martial Arts</option><option value="https://kishymca.org/tai-chi/">- Tai Chi</option><option value="#">- Adult Sport Leagues»</option><option value="https://kishymca.org/adult-roller-hockey-league/">- Adult Roller Hockey League</option><option value="https://kishymca.org/co-ed-volleyball-league/">- CO-ED Adult Volleyball League</option><option value="#">- Aquatics»</option><option value="#">- Swim»</option><option value="https://kishymca.org/swim-lessons/">- Swim Lessons</option><option value="https://kishymca.org/private-swim-lessons/">- Private Swim Lessons</option><option value="https://kishymca.org/dekalb-county-swim-team-dcst/">- Dekalb County Swim Team (DCST)</option><option value="https://kishymca.org/dcst-private-swim-lessons/">- DCST Private Swim Lessons</option><option value="#">- Healthy Living»</option><option value="#">- Exercise Classes»</option><option value="https://kishymca.org/waterexerciseclasses/">- Water Exercise Classes</option><option value="https://kishymca.org/functional-training-classes/">- Functional Training Classes</option><option value="https://kishymca.org/pedaling-for-parkinsons/">- Pedaling for Parkinson's</option><option value="https://kishymca.org/prenatal-strength-birth-prep/">- Prenatal Strength & Birth Prep</option><option value="https://kishymca.org/project-phoenix/">- Project Phoenix</option><option value="https://kishymca.org/wellness-center-orientations/">- Wellness Center Orientations</option><option value="https://kishymca.org/personal-training-form/">- Personal Training</option><option value="#">Rentals»</option><option value="https://kishymca.org/birthday-party/">- Birthday Party</option><option value="https://kishymca.org/facility-rentals/">- Facility Rentals</option><option value="https://kishymca.org/gt3_gallery/kishwaukee-family-ymca-photo-gallery/">- Facility Photo Gallery</option><option value="https://kishymca.org/schedules/">Schedules</option><option value="#">Events»</option><option value="https://kishymca.org/2025-third-annual-art-contest/">- 2025 Third Annual Art Contest</option><option value="https://kishymca.org/family-fun-nights/">- Family Fun Nights</option><option value="https://kishymca.org/aquatics-easter-egg-hunt-roller-skating-night/">- Aquatics Easter Egg Hunt & Roller Skating Night</option><option value="https://kishymca.org/lunch-learn-series-with-northern-rehab/">- Lunch & Learn – Series with Northern Rehab and Hy-Vee</option><option value="#">Membership»</option><option value="https://kishymca.org/benefits-membership/">- Benefits of Membership</option><option value="https://kishymca.org/join-the-y/">- Join the Y</option><option value="https://kishymca.org/open-doors/">- Open Doors Financial Aid</option><option value="https://kishymca.org/corporate-membership/">- Corporate Membership</option><option value="https://kishymca.org/nationwide-ymca-membership/">- Nationwide YMCA Membership</option><option value="https://kishymca.org/policies/">- Policies</option><option value="https://kishymca.org/facility-usage-requirements/">- Facility Usage Requirements</option><option value="#">Work for the Y»</option><option value="https://kishymca.org/online-employment-application/">- Employment/Volunteer Application</option><option value="https://kishymca.org/2025-summer-camp-now-hiring/">- 2025 Summer Camp: NOW HIRING</option><option value="https://kishymca.org/why-work-for-the-y/">- Why Work for the Y</option><option value="#">Donate»</option><option value="https://kishymca.org/donate/">- Donate</option><option value="https://kishymca.org/donor-privacy-policy/">- Donor Privacy Policy</option><option value="https://kishymca.org/y-stories/">- Y Stories</option><option value="https://kishymca.org/volunteer/">- Volunteer</option><option value="https://kishymca.org/contact-us/">Contact Us</option></select> </div> </div> </div> </div> <div class="container buttons"> <a href="https://kishymca.org/program_type/youth-development"><img src="https://kishymca.org/wp-content/themes/kish-ymca/images/call-youth.png" /><span>Youth Development Alerts</span></a> <a href="https://kishymca.org/program_type/healthy-living"><img src="https://kishymca.org/wp-content/themes/kish-ymca/images/call-heathy.png" /><span>Healthy Living</a></span> <a href="https://kishymca.org/program_type/social-responsibility"><img src="https://kishymca.org/wp-content/themes/kish-ymca/images/call-social.png" /><span>Social Responsibiliy</a></span> </div> <div class="container"> <div class="sixteen columns alpha"> <div id="primary" class="full-width"> <div id="content"> <div class="two-thirds column alpha"> <div class="main"> <article id="post-168" class="post-168 page type-page status-publish hentry" role="article"> <header class="entry-header"> <h1 class="entry-title">Open Doors</h1> </header> <div class="entry-content"> <h2>Open Doors Membership Program</h2> <p>As the nation’s leading nonprofit dedicated to youth development, healthy living, and social responsibility, the Y is committed to giving everyone in our community the opportunity to learn, grow and thrive, regardless of their financial circumstances.</p> <p>That’s why we offer our Open Doors Program, which offers reduced membership rates to individuals and families whose financial circumstances may not allow them to pay the full membership rate. Members who experience a temporary financial setback, such as a job loss, are also encouraged to seek temporary membership assistance through the Y’s Open Doors program. The Y can provide financial assistance thanks to caring individuals and businesses who donate to our Annual Giving Campaign.</p> <h2>How to Apply</h2> <ul> <li>Complete the online Open Doors application below and upload your most recent tax return or VNF (Verification of Non-filing) letter from the IRS Website (Go to: <a href="http://www.irs.gov/individuals/get-transcript" target="_blank" rel="noopener noreferrer" data-auth="NotApplicable" data-linkindex="1">www.irs.gov/individuals/get-transcript</a> )</li> <li>Complete the <a href="https://kishymca.org/wp-content/uploads/2023/12/Open-Doors-Brochure-Tri-fold-v2.pdf">Open Doors Application</a>, and bring it to the Kishwaukee Family YMCA along with your most recent tax return or VNF (Verification of Non-filing) letter from the IRS Website (Go to: <a href="http://www.irs.gov/individuals/get-transcript" target="_blank" rel="noopener noreferrer" data-auth="NotApplicable" data-linkindex="1">www.irs.gov/individuals/get-transcript</a> )</li> <li>Let our staff know that you’d like to discuss membership through Open Doors.</li> </ul> <p>With any questions, please contact CFO, Charlie Irick at 815.375.5376 or cirick@kishymca.org</p> <hr /> <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_20' > <div class='gform_heading'> <h3 class="gform_title">Open Doors Membership Application</h3> <p class='gform_description'></p> </div><form method='post' enctype='multipart/form-data' id='gform_20' action='/open-doors/' data-formid='20' novalidate> <div class='gform-body gform_body'><ul id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id="field_20_2" class="gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_2" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Application Type<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_2'><li class='gchoice gchoice_20_2_1'> <input class='gfield-choice-input' name='input_2.1' type='checkbox' value='New Application' id='choice_20_2_1' /> <label for='choice_20_2_1' id='label_20_2_1' class='gform-field-label gform-field-label--type-inline'>New Application</label> </li><li class='gchoice gchoice_20_2_2'> <input class='gfield-choice-input' name='input_2.2' type='checkbox' value='Renewal Application' id='choice_20_2_2' /> <label for='choice_20_2_2' id='label_20_2_2' class='gform-field-label gform-field-label--type-inline'>Renewal Application</label> </li></ul></div></li><li id="field_20_4" class="gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_4" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_4'> <span id='input_20_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_4.3' id='input_20_4_3' value='' aria-required='true' /> <label for='input_20_4_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_4.6' id='input_20_4_6' value='' aria-required='true' /> <label for='input_20_4_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_22" class="gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_22" ><label class='gfield_label gform-field-label' for='input_20_22'>Date of Birth<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_date'> <input name='input_22' id='input_20_22' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon' placeholder='mm/dd/yyyy' aria-describedby="input_20_22_date_format" aria-invalid="false" aria-required="true"/> <span id='input_20_22_date_format' class='screen-reader-text'>MM slash DD slash YYYY</span> </div> <input type='hidden' id='gforms_calendar_icon_input_20_22' class='gform_hidden' value='https://kishymca.org/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg'/></li><li id="field_20_5" class="gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_5" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_20_5' > <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_20_5_1_container' > <input type='text' name='input_5.1' id='input_20_5_1' value='' aria-required='true' /> <label for='input_20_5_1' id='input_20_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_20_5_2_container' > <input type='text' name='input_5.2' id='input_20_5_2' value='' aria-required='false' /> <label for='input_20_5_2' id='input_20_5_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_20_5_3_container' > <input type='text' name='input_5.3' id='input_20_5_3' value='' aria-required='true' /> <label for='input_20_5_3' id='input_20_5_3_label' class='gform-field-label gform-field-label--type-sub '>City</label> </span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_20_5_4_container' > <input type='text' name='input_5.4' id='input_20_5_4' value='' aria-required='true' /> <label for='input_20_5_4' id='input_20_5_4_label' class='gform-field-label gform-field-label--type-sub '>State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_20_5_5_container' > <input type='text' name='input_5.5' id='input_20_5_5' value='' aria-required='true' /> <label for='input_20_5_5' id='input_20_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_20_5_6_container' > <select name='input_5.6' id='input_20_5_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cabo Verde' >Cabo Verde</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo' >Congo</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czechia' >Czechia</option><option value='Côte d'Ivoire' >Côte d'Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini' >Eswatini</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Korea, Democratic People's Republic of' >Korea, Democratic People's Republic of</option><option value='Korea, Republic of' >Korea, Republic of</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People's Democratic Republic' >Lao People's Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macao' >Macao</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Macedonia' >North Macedonia</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russian Federation' >Russian Federation</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria Arab Republic' >Syria Arab Republic</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='Türkiye' >Türkiye</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Viet Nam' >Viet Nam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_20_5_6' id='input_20_5_6_label' class='gform-field-label gform-field-label--type-sub '>Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_20_6" class="gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_6" ><label class='gfield_label gform-field-label' for='input_20_6'>Phone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_20_6' type='tel' value='' class='medium' aria-required="true" aria-invalid="false" /></div></li><li id="field_20_7" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_7" ><label class='gfield_label gform-field-label' for='input_20_7'>Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_7' id='input_20_7' type='email' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_20_16" class="gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_16" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_16'><li class='gchoice gchoice_20_16_1'> <input class='gfield-choice-input' name='input_16.1' type='checkbox' value='Male' id='choice_20_16_1' /> <label for='choice_20_16_1' id='label_20_16_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_16_2'> <input class='gfield-choice-input' name='input_16.2' type='checkbox' value='Female' id='choice_20_16_2' /> <label for='choice_20_16_2' id='label_20_16_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_16_3'> <input class='gfield-choice-input' name='input_16.3' type='checkbox' value='Unspecified' id='choice_20_16_3' /> <label for='choice_20_16_3' id='label_20_16_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_3" class="gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_3" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Membership Category (please select one)<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_3'><li class='gchoice gchoice_20_3_1'> <input class='gfield-choice-input' name='input_3.1' type='checkbox' value='Family' id='choice_20_3_1' /> <label for='choice_20_3_1' id='label_20_3_1' class='gform-field-label gform-field-label--type-inline'>Family</label> </li><li class='gchoice gchoice_20_3_2'> <input class='gfield-choice-input' name='input_3.2' type='checkbox' value='Adult' id='choice_20_3_2' /> <label for='choice_20_3_2' id='label_20_3_2' class='gform-field-label gform-field-label--type-inline'>Adult</label> </li><li class='gchoice gchoice_20_3_3'> <input class='gfield-choice-input' name='input_3.3' type='checkbox' value='Youth' id='choice_20_3_3' /> <label for='choice_20_3_3' id='label_20_3_3' class='gform-field-label gform-field-label--type-inline'>Youth</label> </li><li class='gchoice gchoice_20_3_4'> <input class='gfield-choice-input' name='input_3.4' type='checkbox' value='Senior' id='choice_20_3_4' /> <label for='choice_20_3_4' id='label_20_3_4' class='gform-field-label gform-field-label--type-inline'>Senior</label> </li><li class='gchoice gchoice_20_3_5'> <input class='gfield-choice-input' name='input_3.5' type='checkbox' value='Senior Family' id='choice_20_3_5' /> <label for='choice_20_3_5' id='label_20_3_5' class='gform-field-label gform-field-label--type-inline'>Senior Family</label> </li><li class='gchoice gchoice_20_3_6'> <input class='gfield-choice-input' name='input_3.6' type='checkbox' value='College Student' id='choice_20_3_6' /> <label for='choice_20_3_6' id='label_20_3_6' class='gform-field-label gform-field-label--type-inline'>College Student</label> </li></ul></div></li><li id="field_20_24" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_24" ><h2 class="gsection_title">Additional Members of your Household</h2></li><li id="field_20_9" class="gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_9" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name</label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_9'> <span id='input_20_9_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_9.3' id='input_20_9_3' value='' aria-required='false' /> <label for='input_20_9_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_9_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_9.6' id='input_20_9_6' value='' aria-required='false' /> <label for='input_20_9_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_15" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_15" ><label class='gfield_label gform-field-label' for='input_20_15'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_20_15' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_8" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_8" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_8'><li class='gchoice gchoice_20_8_1'> <input class='gfield-choice-input' name='input_8.1' type='checkbox' value='Male' id='choice_20_8_1' /> <label for='choice_20_8_1' id='label_20_8_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_8_2'> <input class='gfield-choice-input' name='input_8.2' type='checkbox' value='Female' id='choice_20_8_2' /> <label for='choice_20_8_2' id='label_20_8_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_8_3'> <input class='gfield-choice-input' name='input_8.3' type='checkbox' value='Unspecified' id='choice_20_8_3' /> <label for='choice_20_8_3' id='label_20_8_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_17" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_17" ><label class='gfield_label gform-field-label' for='input_20_17'>Age</label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_20_17' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_25" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_25" ><h2 class="gsection_title"></h2></li><li id="field_20_18" class="gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_18" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name</label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_18'> <span id='input_20_18_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_18.3' id='input_20_18_3' value='' aria-required='false' /> <label for='input_20_18_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_18_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_18.6' id='input_20_18_6' value='' aria-required='false' /> <label for='input_20_18_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_19" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_19" ><label class='gfield_label gform-field-label' for='input_20_19'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_20_19' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_20" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_20" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_20'><li class='gchoice gchoice_20_20_1'> <input class='gfield-choice-input' name='input_20.1' type='checkbox' value='Male' id='choice_20_20_1' /> <label for='choice_20_20_1' id='label_20_20_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_20_2'> <input class='gfield-choice-input' name='input_20.2' type='checkbox' value='Female' id='choice_20_20_2' /> <label for='choice_20_20_2' id='label_20_20_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_20_3'> <input class='gfield-choice-input' name='input_20.3' type='checkbox' value='Unspecified' id='choice_20_20_3' /> <label for='choice_20_20_3' id='label_20_20_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_21" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_21" ><label class='gfield_label gform-field-label' for='input_20_21'>Age</label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_20_21' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_26" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_26" ><h2 class="gsection_title"></h2></li><li id="field_20_27" class="gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_27" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name</label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_27'> <span id='input_20_27_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_27.3' id='input_20_27_3' value='' aria-required='false' /> <label for='input_20_27_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_27_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_27.6' id='input_20_27_6' value='' aria-required='false' /> <label for='input_20_27_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_28" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_28" ><label class='gfield_label gform-field-label' for='input_20_28'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_20_28' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_34" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_34" ><label class='gfield_label gform-field-label' for='input_20_34'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_20_34' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_29" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_29" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_29'><li class='gchoice gchoice_20_29_1'> <input class='gfield-choice-input' name='input_29.1' type='checkbox' value='Male' id='choice_20_29_1' /> <label for='choice_20_29_1' id='label_20_29_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_29_2'> <input class='gfield-choice-input' name='input_29.2' type='checkbox' value='Female' id='choice_20_29_2' /> <label for='choice_20_29_2' id='label_20_29_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_29_3'> <input class='gfield-choice-input' name='input_29.3' type='checkbox' value='Unspecified' id='choice_20_29_3' /> <label for='choice_20_29_3' id='label_20_29_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_30" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_30" ><label class='gfield_label gform-field-label' for='input_20_30'>Age</label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_20_30' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_31" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_31" ><h2 class="gsection_title"></h2></li><li id="field_20_32" class="gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_32" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name</label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_32'> <span id='input_20_32_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_32.3' id='input_20_32_3' value='' aria-required='false' /> <label for='input_20_32_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_32_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_32.6' id='input_20_32_6' value='' aria-required='false' /> <label for='input_20_32_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_38" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_38" ><label class='gfield_label gform-field-label' for='input_20_38'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_20_38' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_35" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_35" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_35'><li class='gchoice gchoice_20_35_1'> <input class='gfield-choice-input' name='input_35.1' type='checkbox' value='Male' id='choice_20_35_1' /> <label for='choice_20_35_1' id='label_20_35_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_35_2'> <input class='gfield-choice-input' name='input_35.2' type='checkbox' value='Female' id='choice_20_35_2' /> <label for='choice_20_35_2' id='label_20_35_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_35_3'> <input class='gfield-choice-input' name='input_35.3' type='checkbox' value='Unspecified' id='choice_20_35_3' /> <label for='choice_20_35_3' id='label_20_35_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_36" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_36" ><label class='gfield_label gform-field-label' for='input_20_36'>Age</label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_20_36' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_37" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_37" ><h2 class="gsection_title"></h2></li><li id="field_20_39" class="gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_39" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name</label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_39'> <span id='input_20_39_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_39.3' id='input_20_39_3' value='' aria-required='false' /> <label for='input_20_39_3' class='gform-field-label gform-field-label--type-sub '>First</label> </span> <span id='input_20_39_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' > <input type='text' name='input_39.6' id='input_20_39_6' value='' aria-required='false' /> <label for='input_20_39_6' class='gform-field-label gform-field-label--type-sub '>Last</label> </span> </div></li><li id="field_20_33" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_33" ><label class='gfield_label gform-field-label' for='input_20_33'>Relationship</label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_20_33' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_40" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_40" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Gender</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_40'><li class='gchoice gchoice_20_40_1'> <input class='gfield-choice-input' name='input_40.1' type='checkbox' value='Male' id='choice_20_40_1' /> <label for='choice_20_40_1' id='label_20_40_1' class='gform-field-label gform-field-label--type-inline'>Male</label> </li><li class='gchoice gchoice_20_40_2'> <input class='gfield-choice-input' name='input_40.2' type='checkbox' value='Female' id='choice_20_40_2' /> <label for='choice_20_40_2' id='label_20_40_2' class='gform-field-label gform-field-label--type-inline'>Female</label> </li><li class='gchoice gchoice_20_40_3'> <input class='gfield-choice-input' name='input_40.3' type='checkbox' value='Unspecified' id='choice_20_40_3' /> <label for='choice_20_40_3' id='label_20_40_3' class='gform-field-label gform-field-label--type-inline'>Unspecified</label> </li></ul></div></li><li id="field_20_44" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_44" ><label class='gfield_label gform-field-label' for='input_20_44'>Age</label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_20_44' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_45" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_45" ><h2 class="gsection_title">Income Information</h2></li><li id="field_20_46" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_46" ><label class='gfield_label gform-field-label' for='input_20_46'>Employer</label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_20_46' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_47" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_47" ><label class='gfield_label gform-field-label' for='input_20_47'>Gross Monthly Income (before taxes)</label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_20_47' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_48" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_48" ><label class='gfield_label gform-field-label' for='input_20_48'>Length of Employment</label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_20_48' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_49" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_49" ><label class='gfield_label gform-field-label' for='input_20_49'>Position</label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_20_49' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_51" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_51" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Part Time or Full Time (please select one)</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_51'><li class='gchoice gchoice_20_51_1'> <input class='gfield-choice-input' name='input_51.1' type='checkbox' value='Full Time' id='choice_20_51_1' /> <label for='choice_20_51_1' id='label_20_51_1' class='gform-field-label gform-field-label--type-inline'>Full Time</label> </li><li class='gchoice gchoice_20_51_2'> <input class='gfield-choice-input' name='input_51.2' type='checkbox' value='Part Time' id='choice_20_51_2' /> <label for='choice_20_51_2' id='label_20_51_2' class='gform-field-label gform-field-label--type-inline'>Part Time</label> </li></ul></div></li><li id="field_20_52" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_52" ><h2 class="gsection_title"></h2></li><li id="field_20_53" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_53" ><label class='gfield_label gform-field-label' for='input_20_53'>Employer</label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_20_53' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_54" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_54" ><label class='gfield_label gform-field-label' for='input_20_54'>Gross Monthly Income (before taxes)</label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_20_54' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_55" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_55" ><label class='gfield_label gform-field-label' for='input_20_55'>Length of Employment</label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_20_55' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_56" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_56" ><label class='gfield_label gform-field-label' for='input_20_56'>Position</label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_20_56' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_57" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_57" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Part Time or Full Time (please select one)</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_57'><li class='gchoice gchoice_20_57_1'> <input class='gfield-choice-input' name='input_57.1' type='checkbox' value='Full Time' id='choice_20_57_1' /> <label for='choice_20_57_1' id='label_20_57_1' class='gform-field-label gform-field-label--type-inline'>Full Time</label> </li><li class='gchoice gchoice_20_57_2'> <input class='gfield-choice-input' name='input_57.2' type='checkbox' value='Part Time' id='choice_20_57_2' /> <label for='choice_20_57_2' id='label_20_57_2' class='gform-field-label gform-field-label--type-inline'>Part Time</label> </li></ul></div></li><li id="field_20_58" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_58" ><h2 class="gsection_title"></h2></li><li id="field_20_59" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_59" ><label class='gfield_label gform-field-label' for='input_20_59'>Employer</label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_20_59' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_60" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_60" ><label class='gfield_label gform-field-label' for='input_20_60'>Gross Monthly Income (before taxes)</label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_20_60' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_61" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_61" ><label class='gfield_label gform-field-label' for='input_20_61'>Length of Employment</label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_20_61' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_62" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_62" ><label class='gfield_label gform-field-label' for='input_20_62'>Position</label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_20_62' type='text' value='' class='medium' aria-invalid="false" /></div></li><li id="field_20_63" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_63" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Part Time or Full Time (please select one)</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_20_63'><li class='gchoice gchoice_20_63_1'> <input class='gfield-choice-input' name='input_63.1' type='checkbox' value='Full Time' id='choice_20_63_1' /> <label for='choice_20_63_1' id='label_20_63_1' class='gform-field-label gform-field-label--type-inline'>Full Time</label> </li><li class='gchoice gchoice_20_63_2'> <input class='gfield-choice-input' name='input_63.2' type='checkbox' value='Part Time' id='choice_20_63_2' /> <label for='choice_20_63_2' id='label_20_63_2' class='gform-field-label gform-field-label--type-inline'>Part Time</label> </li></ul></div></li><li id="field_20_64" class="gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_64" ><label class='gfield_label gform-field-label' for='input_20_64'>Attach copies of your most recent Federal Tax Returns or your VNF from the IRS<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='268435456' /><input name='input_64' id='input_20_64' type='file' class='medium' aria-describedby="gfield_upload_rules_20_64 gfield_description_20_64" onchange='javascript:gformValidateFileSize( this, 268435456 );' /><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_20_64'>Max. file size: 256 MB.</span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_20_64'></div></div><div class='gfield_description' id='gfield_description_20_64'>The Member Experience Director may contact you for additional information if needed or an appointment may need to be scheduled. </div></li><li id="field_20_65" class="gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_65" ><label class='gfield_label gform-field-label' for='input_20_65'>Statement of Need<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_65' id='input_20_65' class='textarea medium' aria-describedby="gfield_description_20_65" aria-required="true" aria-invalid="false" rows='10' cols='50'></textarea></div><div class='gfield_description' id='gfield_description_20_65'>Please explain how an Open Doors membership will positively affect you and or your household. Please note that if not completed the application will not be processed. </div></li><li id="field_20_66" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_20_66" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_consent'><input name='input_66.1' id='input_20_66_1' type='checkbox' value='1' aria-describedby="gfield_consent_description_20_66" aria-required="true" aria-invalid="false" /> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label" for='input_20_66_1' >I verify that the above information is accurate.</label><input type='hidden' name='input_66.2' value='I verify that the above information is accurate.' class='gform_hidden' /><input type='hidden' name='input_66.3' value='5' class='gform_hidden' /></div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_20_66'>I verify that the above information is accurate. I understand that I will inform the YMCA of any changes to my income. I understand that my membership can be terminated if false information is presented. I understand that my Open Doors Membership will need to be renewed every year or when requested by the YMCA. <br /> <br /> The YMCA requires that individuals reapply when their<br /> membership expires (one full year from approval date)<br /> or when requested to keep the information on their<br /> application updated. The ability of the YMCA to respond<br /> to requests for assistance is dependent upon the<br /> success of fundraising projects and current operating<br /> financial situation. Open Doors rarely covers 100% of<br /> the total membership fee. Your fees are subject to<br /> increase when you reapply. 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