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Grandkids Educated and Motivated (GEM) to Succeed
GEM









Grandkids Educated and Motivated…To Succeed
Scholarship Application

Student Name:
Birth Date:
Address:
City:
State, Zip:
Phone:
Alternate Phone:
Email Address:


Name of Grandparent/s:
Address:
City:
State, Zip:
Phone:
Alternate Phone:
Email Address:

Number of years raised by grandparent/s:

Name of High School:
Name of Post Secondary Institution:
GPA:


Please answer the Essay question below (500 words) in 12pt/Times New
Roman:
How has your grandparent/s been an influence in your life?


Submit Application, Essay and Supporting Documents by mail or email to:
P.O. Box 34105
Detroit, MI  48234
cwhite@supportagem.org

Deadline: August 30, 2012
APPLICATION