Our Gift For the Ages:
The Class of 2001 Millennium Scholarship

Name: ________________________________________ Date: _______________________

I am pleased to confirm my intention of contributing a total of $_________ to the Class of 2001 Millennium Scholarship Fund at Rensselaer Polytechnic Institute. I reserve the right to alter these gift plans if unforseen circumstances so warrant. This is an intent and not construed to be legally enforceable.

Total Pledge Commitment Amount: $___________

Yearly Payments:
2001-2002 $_______ 2002-2003 $_______ 2003-2004 $_______ 2004-2005 $_______ 2005-2006 $_______ (Reunion Year Celebration)

Please let us know your preference on being reminded each year:
____ E-mail ____ Home Address

E-mail Address (after June 1, 2001): ______________________
Do not forget that the Alumni House offers FREE email for life. Visit www.alumni.rpi.edu for details.

Home Address (after June 1, 2001):
Street Address ________________________________
City __________________________________________
State ______________________ Zip _______________
Phone (____)____-_______
Social Security Number __ __ __ - __ __ - __ __ __ __

Business Information:
Employer's Name _____________________________
Business Street Address ________________________
City __________________________________________
State ______________________ Zip _______________
Position ______________________________________
Phone (____)____-_______

You can also submit your first gift via MasterCard or Visa online at www.alumni.rpi.edu/give. Be sure to specify the 2001 Millennium Scholarship.

Thank you for your gift

Please print out this form and mail to:

Class of 2001 Millenium Scholarship
Rensselaer Polytechnic Institute
Institute Advancement
110 8th Street
Troy, NY 12180-3590

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