LONA HULBUSH JACOBS MEMORIAL SCHOLARSHIP

Lona Hulbush Jacobs Memorial Scholarship Award Application

The Association may award up to $1000 for the Lona Hulbush Jacobs Scholarship to a first-year dental hygiene student who shows scholastic aptitude and need for financial assistance. This award is presented at the Symposium for Oral Healthcare Professionals.

Application deadline 2nd Friday of January by 4 pm PST
Date Submitted

MonthDayYear
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Submitted By
Address
Cell
Email
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Dental Hygiene School
Year of Graduation
Marital Status
Number of Dependents
Previous Occupations
Source of funding for first year of dental hygiene education? Savings, Personal Loan, Work, Other (Please list amounts)
What is your current plan to finance your second year of education? Include financial total from each planned source. Include anything you feel is important onthis issue.
During your current year, have you been the recipient of any scholarships, awards, grants, financial aid or educational loans? Please list name, amount and if it will continue this next year:
List all the schools you have attended post high school. (Include a transcript from each school, with cumulative GPA. These do not need to be certified copies.)
Please identify any other financial aid for which you are applying to assist you in financing your second year of dental hygiene school: (include the amount)
Personal and Professional Goals: Please submit a brief essay that addresses the following: A. Describe why you are pursuing a career in dental hygiene. B. Describe your most important campus activities: include honors, awards and special projects. C. Describe your extracurricular activities, volunteer work or public service:
Upload Recommendation Letters

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Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Questions please email info@wsdha.org
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