• Gillette Hayden Memorial Foundation

    Practice Management Scholarship Application, 2022
  • Mission

    Our mission is to support the future of women dentist leadership in the American Association of Women Dentists and the Dental Profession. 

    The Scholarship

    Our goal for this scholarship is to support a woman dentist practice owner who meets the eligibility requirements as listed in the application below, in their efforts to learn the business of dentistry. At the same time encourages applicants to practice in a health profession shortage area (HPSA). 

    The scholarship awardee will receive eight (8) - one (1) hour sessions with Shelly Short of ZumWohl Consulting, Zum!! Simple Solutions for Sustainable Success. Each session will be via Zoom and will be recorded for the awardee to review and use in the future with new staff or associates. Some of the topics that will be covered are - Workflows, Marketing, Leadership Development Coaching, Creating a Positive Work Culture, Dental Economics 101, Team Meetings, Hiring, Scheduling and Stress Control to name a few. You will receive a follow-up report after each session and a review at the beginning of the next session. 

    Qualifications

    • Must be a current member of the American Association of Women Dentists (AAWD). 
    • Must be a woman dentist. 
    • Must be actively practicing dentistry. 
    • Applicant holds an active/current US or Canadian Dental License. 
    • Current Dental Practice Owner,  5 year or less within the United States, Canada, Puerto Rico and the US Virgin Islands. 
    • Dentists in a Health Profession Shortage Area (HPSA).  

    Application Process

    To apply for the scholarship please submit the following items:

    • Complete and submit the following application. 
    • Curriculum Vitae.
    • 500 Word Essay (typed in PDF format). The essay should describe why you chose to practice in a Health Profession Shortage Area (HPSA) and how the scholarship will impact your business. 
    • Video of yourself, 90 seconds or less that indicates how this award will be beneficial to your circumstances. NO more than 1.5 minutes will be accepted. Video should be submitted as an MP4. 

    Deadline

    A complete application along with the above-listed documents and video must be submitted no later than November 1, 2022. 

    Selection Process

    All complete applications will be reviewed by the GHMF Board of Trustees. Each Trustee will grade each portion of the application independently. The scores will be totaled and discussed. One scholarship winner shall be selected. All decisions by the Board of Trustees will be final. The scholarship recipient will be notified via email no later than December 31, 2022. 

    Only one scholarship per person will be awarded in the lifetime of the program. Applicants who are not selected to receive the aware may apply again. 

    Acknowledgement

    The scholarship recipient shall claim their award by notifying the Gillette Hayden Memorial Foundation Board of Trustees no later than January 15, 2023, via email at: ghmfoundation@gmail.com. 

     

    Disbursement

    Scholarship disbursement will be paid directly to ZumWohl! 

    Please submit all questions to: ghmfoundation@gmail.com

    https://ghmfoundation.weebly.com

     

     

  • Personal/Business Information

  •  -
  • Academic Information

  • Essay and Video Submission

  • Browse Files
    Cancel of
  • Browse Files
    Cancel of
  • Scholarship Terms and Conditions

    Release Authorization and Certification of Accuracy
  • I certify that this information is complete and accurate. I authorize the release of this information to confirm and/or verify this application. I further grant the GHMF the right to use my name and likeness in connection with the promotion of the GHMF Practice Management Scholarship on, but not limited to, our website, email distribution, and social media platforms. I also agree to provide a photograph and a brief biography for publication if I am selected to receive the scholarship. 

    I certify that I meet the eligibility criteria for the GHMF Practice Management Scholarship and have attached my essay submission and video. I understand that applications that are incomplete, late or not submitted in accordance with directions will be ineligible for consideration. 

    I hereby apply for the GHMF Practice Management Scholarship. I understand if I am selected to receive the scholarship, the GHMF has no legal liability or obligation to me other than the payment of the Scholarship Award on my behalf to the practice management company, ZumWohl. I further understand that if I choose not to enroll after payment of the Scholarship, I am responsible to notify ZumWohl directly and notify the GHMF of my decision. 

     

  • Clear
  •  -  -
    Pick a Date
  •  
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free! Create your own Jotform