1. Energetic Einsteins Scholarship for Gifted Students

Dear Gifted Student and Parents/Guardians,

Thank you for your interest in our Scholarship Program for Gifted Students. Please take a moment to answer all of the questions on this application form. Students under the age of 18 must provide parental information where it is requested on the application and must obtain parental permission.
Some questions must be answered by the student in their own words. These are clearly marked.
The questions on the second page will be used to determine financial need. These questions must be answered by an adult or an individual over 18 years of age. These answers will be kept confidential.
We accept donations for scholarships from individuals and organizations. The number and dollar amount of the scholarships awarded will depend on the donations and grants that are obtained for this effort.

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

* 1. For the following questions please provide the information requested. Please provide the student's permanent address.

* 2. We are currently taking scholarship applications for summer 2013. Which session(s) are you registering for.

* 3. Please answer the following question with the Month Day and Year.

Date of Student's birth
/
/

* 4. Gender

* 5. Please indicate type of gifted program that you participate(ed) in during the school year (mark as many as apply).

* 6. Current Grade Level (2012-2013 school year)

* 7. Please Indicate your GPA for THE MOST RECENT 3 YEARS. Include this current year if you have gotten any report cards thus far. Please convert all grades to a 4 point scale. Thus, all A's are worth 4 points regardless of AP or other status. Also, for schools that do not give grades in the early years, please convert the grades such that the highest option is a 4.

  3.5-4.0 3.0-3.49 2.5-2.99 2.0-2.49 1.5-1.99 1.0-1.49 0.0-0.99
K
1
2
3
4
5
6
7
8
9
10
11
12
College Freshman
College Sophomore
College Junior
College Senior
Other College

* 8. Please mark all of the courses below that you took in middle school (Grades 5-8). (Please skip question for students under Grade 5.)

  Honors/Advanced Pre-AP AP IB
Biology
Chemistry
Physics
Psychology
Algebra I
Geometry
Algebra II
Pre-Calculus
Calculus
Statistics

* 9. Please mark all of the courses below that you took in high school. (Please skip question for students under Grade 9.)

  Honors AP IB
Biology
Chemistry
Physics
Psychology
Algebra I
Geometry
Algebra II
Pre-Calculus
Calculus
Statistics

* 10. Please indicate any academic competitions that you have been involved with in the past 3 school years. Please mark Participation for any event in which you did not earn first place even if you received another award. Please try to choose the closest category to the competition in which you participated even if it is not an exact match.

  2012-2013 2011-2012 2010-2011
Science Fair Participation
Science Fair 1st Place
Other Science Competition Participation
Other Science Competition 1st Place
Engineering or Robotics Competition Participation
Engineering or Robotics Competition 1st Place
Math Competition Participation
Math Competition 1st Place
Reading Competition Participation
Reading Competition 1st Place
Writing Competition Participation
Writing Competition 1st Place
History Competition Participation
History Competition 1st Place
Social Studies Competition Participation
Social Studies Competition 1st Place
Spelling Competition Participation
Spelling competition 1st Place

* 11. Please list your relevant extracurricular activities. You may ALSO send a copy of your full cv or resume if you have one to GiftedInfo@BioPhi.org. Please notate here if you are doing so.

* 12. In 3-5 sentences, please tell us what you hope to gain by participating in the Energetic Einstein Program that you are seeking a Scholarship for. (This question needs to be answered by the student in their own words.)

* 13. In 3-5 sentences, please tell us what you think you can contribute during the Energetic Einstein Program that you are seeking a Scholarship for. (This question needs to be answered by the student in their own words.)

* 14. Is there any other important information that we should know about your achievements or academic potential? (Parents/Guardians may send testing information to GiftedInfo@BioPhi.org if they would like this to be considered. Please notate here if you are doing so.)

* 15. Please provide the following information. Please do not leave the questions blank and respond with none if there is no other response.

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