Scholarship Information:
Michigan State Representative Rebekah Warren represents the
53rd district, which consists of almost the entire city of
Out of the Envision Michigan Fund, Representative Warren will
be awarding a $500 scholarship to two graduating high school seniors who currently reside in the 53rd
district and plan to attend a university, college, technical or trade school. In order to be eligible for
consideration, students must meet these requirements and complete and return the following application and essay
question by the prescribed deadline.
Application Information:
The application deadline for the scholarship is Monday, March 31st. To return
the application you may either send it via email to rebekahwarren@house.mi.gov or mail it to us at
General Information:
Name _____________________________________
Address ____________________________________
Street Address
Apt. #
_________________ ____ ______
City
State Zip Code
Home Phone ______________
Cell Phone ______________
Email Address _______________________
High School _________________________ GPA _____ /_____
Please list the schools to which you are applying or have applied. Or, if you have already been accepted to
the school of your choice, please attach a copy of the acceptance letter.
Name of School
Date Applied
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
Degree sought (if known) __________________
Awards and Achievements:
Please list the academic and non-academic awards and achievements you have received throughout your high school
career. You may add another sheet if necessary.
Award
Organization
Date
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
Employment:
Please provide your employment history beginning with your most recent job.
Employer Position/Title
Period of Service (mo./yr.)
- ___________________________________________________
- ___________________________________________________
- ___________________________________________________
Extracurricular Organizations and Leadership Activities:
Please list your participation in extracurricular organizations, teams and clubs. You may add another sheet if
necessary.
Organization Official Position Held
Dates
- __________________________________________________
- __________________________________________________
- __________________________________________________
- __________________________________________________
- __________________________________________________
Please briefly state what you consider to be your most important contribution to the above
organizations.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Community Service Activities:
Please list your participation in community service organizations and projects. You may add another sheet if
necessary.
Organization Official Position Held
Dates
- __________________________________________________
- __________________________________________________
- __________________________________________________
- __________________________________________________
- __________________________________________________
Please briefly state how participating in these activities has impacted you.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Essay:
Please print neatly or type your answer to the following essay question in no more than 750 words on
double-spaced pages using 1 inch margins.
Imagine that you are running for Governor in the State of





