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DETROIT AUTOMOTIVE PROJECT RAINBOW PUSH EXCEL- GENERAL MOTORS SCHOLARSHIP APPLICATION FORM 2011 (Please Type or Print) A. Personal Information 1. Full Name (Last, First, Middle) _________________________________________________ 2. Birth Date _____________________3. Gender _______4. U.S. Citizen: YES ___ 5. Cell Phone __________________________6. Home Phone __________________________ 7. E­mail ____________________________________________________________________ 8. Current (School) Mailing Address ____________________________________________________________________________ City_____________________________Zip Code_______ ________________________________________________________________________ 9. Permanent Mailing Address ________________________________________________________________________ City ____________________________Zip Code_______ 10.  Contact Person (i.e. Parent, Guardian) ______________________________________ Email: __________________________________________Phone:____________________ B. Academic Information 1. University/College_______________________________ ________________________ 2. Major/Field of Study (Interest) _____________________________________________ 3. Class Standing (circle one): 1st year / 2nd Year/3rd Year /4th year/Graduate/Other 4. Current GPA _________  5. Previous academic honors, fellowships and awards ______________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 6. Please describe any interests and/or hobbies you have ___________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ C.  Essay Topic (Max 300 words…please attach) “The automobile’s impact on American life is everywhere, for the car is much more than a means of t raveling from one place to another. Please explore in your essay the automobile's impact on American life through design, envi ronment, and labor”. D.  Acknowledgment I certify that the information provided in my application is true and accurate to the best of my knowledge.  ___________________________________ _________________________________ Signature of the applicant (required) Date It is the applicant's responsibility to ensure that five (5) copies of each the following items: two reference letters, a   transcript, the scholars’ application and essay are received and postmarked no later than the deadline July 7, 2011.   Incomplete application packages will not be reviewed.  For more information contact lavoniaperryman@gmail.com.  Mail


all materials to Rainbow PUSH Automotive P roject, 4335 West Fort Street, Detroit, Michigan, 48209...Attention: Rainbow PUSH-GM 2011 Scholars Program.


APPLICATION