Contribution Form Please mail this form with a copy of your approval letter from the Dept of Revenue to



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Contribution Form

Please mail this form with a copy of your approval letter from the Dept. of Revenue to:

GRACE Scholars, Inc. Approval Date: _ _/_ _/_ _ _ _

2401 Lake Park Dr SE

Smyrna, GA 30080

Name: Parish/City: __________ /

E-mail Address: Telephone: ___________________ (Please Indicate: Home/Work/Cell)

Home Address:

I am enclosing a check for $___________ payable to GRACE Scholars, Inc.

GRACE Scholars, Inc. allows donors to designate the scholarship funds to economically disadvantaged students only or to specific schools. If the donor prefers, the GRACE Scholars board will distribute scholarships to schools with the greatest need. If the scholarship needs are filled at the specified school, funds will be directed to another school with unmet need in order to comply with state law regarding the annual distribution of funds.

Please note, it is not possible to designate scholarships to specific individuals or families.




You may choose up to three designations by listing the amount for each entity up to the total amount of the check:

($___________) GRACE Scholars Board Choice

($___________)Economically Disadvantaged Family Fund


Schools of the Archdiocese of Atlanta


($___________) Blessed Trinity Catholic High School
($___________) Christ the King Catholic School

($___________) Holy Redeemer Regional Catholic School


($___________) Immaculate Heart of Mary Catholic School
($___________) Our Lady of Mercy Catholic High School
($___________) Our Lady of the Assumption School

($___________) Our Lady of Victory Regional School

($___________) Queen of Angels Regional Catholic School

($___________) St. Catherine of Siena Catholic School


($___________) St. John Neumann Regional School

($___________) St. John the Evangelist Catholic School

(Hapeville)
($___________) St. Joseph Catholic School (Athens)
($___________) St. Joseph Catholic School (Marietta)
($___________) St. Jude the Apostle Catholic School
($___________) St. Mary Catholic School
($___________) St. Peter Claver Regional Catholic School
($___________) St. Pius X Catholic High School
($___________) St. Thomas More Catholic School
($___________) Other independent Catholic School*

____________________________

Schools of the Diocese of Savannah

($___________) Aquinas Catholic High School

($___________) Blessed Sacrament Catholic School

($___________) Immaculate Conception Catholic School

($___________) Mount de Sales Academy

($___________) Notre Dame Academy

($___________) Our Lady of Lourdes Catholic School

($___________) Sacred Heart Catholic School

($___________) St. Anne-Pacelli Catholic School

($___________) St. Frances Cabrini Catholic School

($___________) St. Francis Xavier Catholic School

($___________) St. James Catholic School

($___________) St. John the Evangelist Catholic School

(Valdosta)



($___________) St. Joseph Catholic School

($___________) St. Mary on the Hill Catholic School

($___________) St. Peter Claver Catholic School

($___________) St. Peter the Apostle Catholic School

($___________) St. Teresa Catholic School

($___________) St. Vincent’s Academy

($___________) Other independent Catholic School*

___________________________



* Certain independent Catholic schools may have partnered with other Student Scholarship Organizations (SSO). The amount designated will be forwarded to their partner SSO with the form.


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