Scholarship Application Student / Child Information Future GEM name: Birthday: Address: City: State: Zip: School Name: Grade you are starting in the fall: Tell us why you want to be a GEM: Parent / Legal Guardian Information Parent name: Annual Household Income: Phone: Email Address: Address: City: State: Zip: Address same as above Why do you want your daughter to be a GEM? Sponsorship Requested: $100$250Full ($495)
