DC Dental Society Foundation Scholarship Application

Full Name

Street Address

City

State

Zip Code

Phone

Email

Enrollment Date

Name of recommending person

Relationship of recommending person to applicant

Statement of Purpose

A statement of purpose (not to exceed 500 words), which describes plans for your career in dentistry, why you should be chosen for this scholarship, and your need for financial aid.

Acknowledge:

• I declare that I am enrolled in the Howard University College of Dentistry
• If awarded a scholarship, I consent to the publication of my name, photo and biographical information.
• I declare that the information contained herein is true and accurate.

Type Name to Sign

Submit