DTA Foundation Dental Hygiene Scholarship Application

LAWRENCE AND SALLY COHEN ENDOWED SCHOLARSHIP FOR DENTAL HYGIENE

Application Deadline - March 1, 2025
Thanks to the very generous donation from the Benco Family Foundation, dental hygiene students from underrepresented communities and backgrounds can now apply for a $25,000 scholarship to cover the cost of their tuition for their two year program through the Lawrence and Sally Cohen Endowed Scholarship Fund for Dental Hygiene.

In addition to the scholarship, Young Innovations has graciously agreed to include a complete line of preventative items for the student, along with a set of scrubs and a $500 Gift card for school supplies.
This scholarship is for those from underrepresented communities and backgrounds. Does this apply to you?*

YesNo

Do you qualify for financial aid through programs such as FAFSA?*

YesNo

Have you already been accepted into a 2 year, in person dental hygiene program?*

YesNo

Thank you for your interest in this scholarship. Unfortunately, you are not eligible at this time. However, there are other scholarships out there for dental hygiene school and we encourage you to apply for those!

Here are some resources we hope you find helpful for your dental hygiene journey.

I. Personal Data:

Tell us about yourself
Full Name*

First NameLast Name
Phone Number :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Please list any awards or work experiences that you think are relevant for your future as a dental hygienist (does NOT need to be in paragraph form and we encourage a bulleted list format).

This can be a simple list format. 0/500
II. Your Journey to Dental Hygiene
We are hoping to learn a bit more about you and your dedication to dental hygiene.
Why did you choose dental hygiene school? Why is being a dental hygienist important to you? (max of 750 words)*

0/750
What does perseverance mean to you? Can you provide an example of a time where you had to overcome obstacles, personal or professional, in order to reach your goal or accomplish something? (max of 750 words)*

0/750
V. Dental Hygiene School Information
Which dental hygiene school are you attending?*
Who is the best contact person to reach out to? *
What is their email? *
example@example.com
Do you plan to join any student groups or volunteer anywhere while in school? Are you planning to work while attending school? Please list any roles related below.
VIII. Submitting!
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

Shortly after you have submitted this form, we will send you a link for a short (maximum time of 2 minutes) selfie video. This short, unprofessional video is a great chance for you to give us a better picture of who you are and your unique background. The request will come with a link to a platform where you can directly record and upload through the link, or upload from a separate video system if you have one you prefer.
E-Signature:*
Should be Empty:

LAWRENCE AND SALLY COHEN ENDOWED SCHOLARSHIP FOR DENTAL HYGIENE

I. Personal Data:

II. Your Journey to Dental Hygiene

V. Dental Hygiene School Information

VIII. Submitting!