Gifted Student Scholarship Fund

1. Gifted Student Scholarship Fund

Dear Supporter of Gifted Students,

Thank you in advance for your gift.

We appreciate you making a gift to Energetic Einsteins to help support gifted students. All gifts go directly to fund scholarships. Often times bright students do not have the resources they need to excel; and your gift will help to alleviate this gap. We endeavor to provide scholarships to all students with financial need so that students are not excluded due to financial concerns.

You may also contribute to a non-needs based scholarship fund to reward students for their academic achievement. We also accept gifts of scientific equipment and consumables to offset the cost for all participants.

Thank you again for your gift. If you have any questions or concerns please do not hesitate to contact me.

I look forward to working with you,
Dr. Demetrikopoulos

Melissa K. Demetrikopoulos, Ph.D.
Director of Scientific Communications
Chair, Division of Program Development and Assessment
Energetic Einsteins
GiftedInfo@BioPhi.org
305-240-1522

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* 1. For the following questions please provide the information requested.

Name *

company if applicable

Address *

Address 2

City *

State *

Zip *

Country *

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* 2. What would you like your gift to go towards. You may indicate multiple choices.

Greatest Need

Needs Based Scholarship

Achievement Based Scholarship

Student in Brains and Behavior Program (gifted student who completed 6th-10th grade)

Student in Brain Camp for Brainiacs (gifted student who completed 6th-10th grade)

Student in Wizard Camp for Gifted Muggles (gifted student who completed 3rd-6th grade)

Student in Are You Smarter Than a Rocket-Scientist? (gifted student who completed 5th-8th grade)

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* 3. Please indicate the level of your contribution to the scholarship fund.

$10

$25

$50

$100

$150

$200

$300

$400

$450 (supports one students)

$900 (supports two students)

$1350 (supports three students)

$1800 (supports four students)

$2000 Friend of Albert

$5000 Albert's Inner Circle

$10,000 Albert's Best Friend

Other (please specify)

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* 4. If you would like your gift acknowledged on our webpage and in other possible literature, please indicate how you would like it listed. All gifts below the Friend of Albert level will be grouped together as Gifts to Albert.

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* 5. How did you hear about the program? Please mark as many as apply.

Friend

Teacher

Gifted Association

School Gifted Program

Other Gifted Program

Flier

Energetic Einsteins Website

Other Website

Other (please specify)

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* 6. Is there any other important information that we should know?

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* 7. Refer a Friend: If you know anyone else who may be interested supporting this program, please provide their contact information so that we can send them program information.