2025 HDAF Scholarship Application

Application Status
Recommendation Form ReceivedDean Form ReceivedFinancial Form Received
THE HISPANIC DENTAL ASSOCIATION FOUNDATION in its quest for continuous improvement in the development of oral health professionals presents a scholarship program to students in the field of dentistry. These scholarships will be awarded to support meritorious work by Hispanic/Latino students who seek to advance their scientific and applied clinical knowledge as they enter into the oral health profession. Scholarship amounts vary depending on the Funder of Scholarship. Please refer to each scholarship description for details.

What is the intent of the scholarship?
The intent of the HDA Foundation Scholarship Program is to support promising students as they pursue their academic training. The awarding of these scholarships will support the grantees during their dental, dental residency, and dental hygiene programs.

Who can apply?
These scholarships are open to student members of the Hispanic Dental Association who have been accepted or enrolled into an accredited dental, dental residency, or dental hygiene programs. Students must be a current student member of the Hispanic Dental Association.

How does one apply?
The attached application form must be submitted online to the Hispanic Dental Association Foundation. The application must be received by the Foundation no later June 15, 2025. The application must be submitted in English.

How will the scholarships be awarded?

The Scholarship Committee of the HDA Foundation will review each application on its merit. Areas that will be included are the demonstration of:
- Commitment and dedication to improving the oral health of the Hispanic community
- Community Service (i.e. volunteer efforts in school, medical facilities, church, etc.
- Leadership Skills
- Scholastic Achievement
- Create a bridge to drive Hispanic representation for future generations
What is the timing of the scholarship program?

For the 2025 academic year, the application must be submitted online no later than June 15, 2025. The award decisions will be final and communicated to all applicants by July 23, 2025.
SCHOLARSHIP APPLICATION INSTRUCTIONS
Thank you for applying to the Hispanic Dental Association Foundation Scholarship Program. You may be eligible to receive an award if you meet all program requirements.
Eligibility Requirements
To be considered, you must:
- Be accepted to begin your program or already be enrolled in a CODA accredited dental program, or dental hygiene program in the U.S. or Puerto Rico in the coming academic year (Fall of 2025).
- Be a current HSDA (Hispanic Student Dental Association) member.
- Be a full-time student during the academic year (Fall 2025) for which you are applying.
- Be in good academic standing at your school.
- Show evidence of commitment and dedication to improve the oral health of the Hispanic and other underserved communities and encourage Hispanics/Latinos to join the profession.
- Applicant must not have been a previous recipient of any HDAF Scholarship.
Please read all materials carefully. It is YOUR responsibility to ensure that ALL the necessary materials are received to the HDA Foundation through the online application by the deadline.
Scholarship Application Deadline
- You must submit your completed application to the Hispanic Dental Association Foundation (HDAF) online no later than June 15, 2025.
- The Verification form must be sent directly from the school to the HDAF through the online process no later than June 15, 2025. (Remember you must complete the top portion of the Verification Form.)
- One recommendation must be submitted directly from the Recommender through the online process no later than June 15, 2025. (Remember you must complete the top portion of the Recommendation form.)
- As part of the application, you are required to submit a 2-3 minute YouTube video explaining how you would create and approach an elementary school teacher explaining why and how you would present an oral health care event for their students and secondly - with all the changes in dentistry (AI, Corporate practices, etc.), how can you see this impacting the marginalized communities? Parts of or your complete video may be used in HDA/HDAF/Sponsor publications. Submission of this application gives your approval for said use.
- The award decisions will be communicated to all applicants by July 25, 2025.
- If you are a recipient of any scholarship award, your presence is required at the HSDA Regional Conference in Fort Lauderdale on Friday, September 19th and Saturday, September 20th, 2025 (during the HDA Annual Meeting.) You will be given up to $750 to help cover travel expenses.
FAILURE TO SUBMIT A FULLY COMPLETE APPLICATION WITH ALL THE ITEMS LISTED ABOVE BY THE APPROPRIATE DEADLINE DATE WILL RESULT IN REJECTION OF YOUR ENTIRE APPLICATION.

PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING APPLICATION. ALL APPLICATIONS MUST BE COMPLETED IN ENGLISH.
APPLICANT’S NAME*

First NameLast Name
Email Address (personal)*
example@example.com
Select your School's State:*
Select the state where you will be attending school.
Dental StudentDental Hygiene Student

2025 SCHOLARSHIP APPLICATION

PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING APPLICATION. ALL APPLICATIONS MUST BE TYPED IN ENGLISH.
A. General Information
Applicant Full Name*

First NameLast Name
Mailing Address While in School*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Permanent Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone #*
Format: (000) 000-0000.
Email (school)*
example@example.com
B. Program
DENTAL: DDSDENTAL: DMDDENTAL HYGIENE
School (note year in school)*
Dean or Program Director Name:*

First NameLast Name
Dean or Program Director Email:*
example@example.com
Dean or Program Director Telephone*
Format: (000) 000-0000.
C. Education – List main College and Dental Schools and Dental Hygiene Schools attended. Most recent first.
From:*

MonthDayYear
Date
To:*

MonthDayYear
Date
Degree Earned:*
School:*
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Degree Earned:
School:

D. Community Service

List student, professional association, community-based research and/or volunteer experiences (with dates of participation) that include up to five activities, with preference given to Hispanic community outreach and Hispanic oral health related activities:
Date/Name of Organization/ Brief Description of Activity*
E. Leadership Positions

List any HSDA or other Leadership positions (with dates of participation) you have held while in or leading up to your dental program, or any other examples or your personal leadership experiences List up to five total:
Date/Name of Organization/Position(s) Held*
F. Honors

List any honors and/or awards received in any capacity eg: scholastic achievements, scholarships, community service, leadership, and extracurricular activities (with dates of participation). List up to five total:
Date/Name of Organization/Position(s) Held*
G. Video Essay Submission

Please include a link in the space provided of a 2-3 minute video using YouTube of yourself explaining how you would approach an elementary school teacher on the importance of an oral health care event for their students and how you would carry it out. Secondary – with all the changes in dentistry (Al, Corporate practices, etc) how can you see this impacting the marginizd communities? Your video must be a maximum of three minutes. Please use a plain background with no loud music or visual effects. Start the video with your name, school and program year. Must be a YouTube video link!

Parts of or your whole video may be used in HDA/HDAF/Sponsor publications. Submission of this application gives your approval for said use.
Link to YouTube Video:*
Video Format: must be YouTube video!
H. AUTHORIZATION

I HEREBY AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED WITHIN THIS APPLICATION. I UNDERSTAND ANY MISREPRESENTATION OR OMISSION OF FACTS ARE CAUSE FOR DISQUALIFICATION.
I. Disclaimer

CANDIDATES MUST DISCLOSE ANY POTENTIAL CONFLICTS OR RELATIONSHIPS WITH SCHOLARSHIP CONTRIBUTORS, LEADERSHIP OF THE H.D.A OR H.D.A. FOUNDATION.

If none, please enter n/a.
Name:

First NameLast Name
Relationship:
Signing this application gives the HDA Foundation and corporate sponsors the right to use photographs and videos of the applicant.
Signature*

Clear
Date*

MonthDayYear
Date

2025 SCHOLARSHIP APPLICATION RECOMMENDATION

Applicant must provide one Recommendation letter from a clinical or didactic faculty member or a school administrator. Recommender will receive an email with information on how to submit the letter. Please tell your Recommender to look for it. It may end up in spam. Section to be completed by Applicant (please type):
Name of Applicant
Address:
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Dental School FacultyOther
Recommender Name*
Company or School*
Recommender Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recommender Phone*
Format: (000) 000-0000.
Recommender Email*
example@example.com
YES
Please be sure to notify your Recommender that they will receive the recommendation form by email so they can expect it and complete it in a timely manner.
NOTE: Failure to provide one recommendation will disqualify the application.
Need help? Watch our Help Video.

DEAN / PROGRAM DIRECTOR VERIFICATION
Section to be completed by Applicant (please type):

I hereby authorize the release of my school’s acceptance information to the Hispanic Dental Association Foundation.
Applicant Name*

First NameLast Name
Applicant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I have been accepted in a dental or dental hygiene program at the following school:*
Dean/Program Director’s Email *
example@example.com
YES
Please be sure to notify your Dean / Program Director that they will receive the verification form by email so they can expect it and complete it in a timely manner.
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Note: Failure to complete this Verification will disqualify the applicant from consideration.

FINANCIAL AID VERIFICATION
Applicant must provide contact info of the Financial Aid Officer so they can complete the separate Financial Aid Verification Form.

Section to be completed by Applicant: (please type)

I hereby authorize the release of my financial aid information to the Hispanic Dental Association Foundation.
Applicant Name:*

First NameLast Name
Applicant Signature*

Clear
Date*

MonthDayYear
Date
I have been approved to receive financial aid at the following school:
Name of School:*
Name Financial Aid Officer:*

First NameLast Name
Financial Aid Officer Email:*
example@example.com
Financial Aid Officer Phone:*
Please enter a valid phone number.Format: (000) 000-0000.
YES
Section to be completed by Financial Aid Officer: (please type)
This section hidden from Applicant. To be filled out by Financial Aid Officer only.
Note: Failure to complete the Financial Aid Verification will disqualify the applicant from consideration.
RETURN ONLINE NO LATER THAN June 15, 2025
Questions: 317-714-0037 Email: hdafoundationscholarships@gmail.com
Should be Empty:

SCHOLARSHIP APPLICATION INSTRUCTIONS

Eligibility Requirements

Scholarship Application Deadline

2025 SCHOLARSHIP APPLICATION

2025 SCHOLARSHIP APPLICATION RECOMMENDATION

DEAN / PROGRAM DIRECTOR VERIFICATION

FINANCIAL AID VERIFICATION