Dentistry Downtown Scholarship (2024)
Promote Dental Health
Applicant Information
Applicant Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
US Citizen
*
Yes
No
Home Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Relationship
*
Parent
Grandparent
Other
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Parent/Guardian Phone Number
*
-
Area Code
Phone Number
Parent/Guardian Email
*
example@example.com
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Academic Info
High School Currently Attending
*
Please Select
Columbia High School
Grissom High School
Huntsville High School
Jemison High School
Lee High School
New Century Technology High School
Dates of Attendance
*
Unweighted GPA
*
/4.00
Standardized Tests
Type a question
*
SAT
ACT
Score:
*
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Future Plans
Target Colleges
*
List up to three colleges you are considering to attend
Intended Major
*
Career Objectives
*
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Extracurriculars
List up to five extracurricular activites
Activity or Organization
*
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Awards/Honors & Achievements
Lift up to five awards/honors and achievements
Award/Honor/Achievement
*
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Video Essay
Upload a brief (3-5 minute) video to YouTube and provide the link below. (You may upload the video as "Unlisted" so that we can view it but it remains private.)
Instructions
Please inslude the following topics in your video: - Introduce yourself; hobbies & interests; something unique about yourself - Your future plans for continuing your education and why you should win this scholarship - Your intended college major and how you may use your college degree to help promote dental health
Video Essay Link
*
Enter the link to your video essay
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Required Documents
Standardized Test Score Report
*
Browse Files
SAT or ACT Test Report
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of
Transcript
*
Browse Files
High School Transcript/Grade Report
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Recommendation Letter
Browse Files
Letter of Recommendation
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of
Submit
Should be Empty: