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Menu
Home
About
About WI-DHA
Meet the Leadership
Learn about the Profession
Support the Profession
Letter from the President
Elected Leadership Positions
Events
Event Calendar
Submit an Event
INDIGO Conference and General Assembly
Student Poster Contest
Student Scholarship
Outstanding Service to Dental Hygiene Award
Celebrating You
Legislation
Members & Students
Student Showcase
Employment Opportunities
General Assembly
Resources
Resources
WI-DHA | Documents
News
Submit a Job
Gallery
Application for WI-DHA Student Scholarship
Application for WI-DHA Student Scholarship
Instructions:
1.
Fill out PART ONE of this application (above) a. Be sure to have your program director sign (above) to validate that you are enrolled in the program and are in good academic standing. b. Please type all your information (aside from signature).
2.
PART TWO:
a.
Write an essay that is 500-750 words long.
b.
Do not write your name on the essay or the name of your school.
c.
Do not identify any faculty or staff by name within your essay.
3.
PART THREE:
List activities as an ADHA student member and explain how they will help the student become a better professional dental hygienist. Do not write your name or the name of your program in this part of the scholarship application.
PART ONE
DH Student Name:
First
Last
ADHA Student membership #:
Mailing address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
School / Program:
Which degree are you working on?
Associates Degree
Bachelors Degree
Master’s Degree
PhD
Other
Which other degree?
Expected date of graduation:
Date Format: MM slash DD slash YYYY
Program director signature:
(validating that student is enrolled and in good academic standing)
Today’s date
Date Format: MM slash DD slash YYYY
PART TWO
In what ways has your participation in ADHA student membership impacted your professional development?
*
PART TREE
List activities
Explain how they will help the student become a better professional dental hygienist
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.
