ODA Foundation 2026 Dental Student Scholarship

Dental Student Scholarship

Please make sure you have read the Dental Student Scholarship 2026 Application Guidance document and have all required portions of the application ready to submit. You will not be able to save and come back later to finish this application form, it must be completed and submitted in one session. Complete all questions and upload all required documents. Failure to complete all required sections fully will result in an incomplete application which will not be reviewed for a scholarship. If you have any questions or difficulties with this application, please contact Cassy Patterson, Manager of the ODA Foundation at cassy@oda.org.
Applicant Information
Name*

First NameLast Name
Email*
We will use this email to contact you (if needed) and to notify you of the ODA Foundation's decision on your application.
Cell Phone Number*
Date of Birth*

MonthDayYear
Date
Are you legally an Ohio resident?*

YesNo (if no, you do not meet the requirements for a dental student scholarship)
Number of years you have been a legal Ohio resident:*
Current Address (during school year)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Information
Name of High School Attended*
High School Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School Graduation Year*
Name of Undergraduate College Attended*
Bachelor's Degree Graduation Year*
Additional degrees attained (provide university name, type of degree and year)
Dental School currently attending*

Case Western Reserve University School of Dental MedicineOhio State University College of DentistryNon-Ohio dental school
If you are attending a non-Ohio dental school, please list the name of the school below:
Class level in September 2026*

D2D3D4
University Student ID Number
ASDA Involvement

Please note: If you are not a member of your ASDA chapter, you do not qualify for the ODA Foundation Dental Student Scholarship. Please join your chapter to qualify.
Are you a member of your dental school ASDA chapter?*

YesNo
ASDA ID Number*
ASDA positions in local chapter: please list any past or current leadership positions you have held within your dental school's ASDA chapter
National ASDA positions: please list any past or current leadership positions you have held within national ASDA leadership
Scholarships, Honors and Awards
Previous ODA Foundation Scholarship Awards: Please list the years and amounts of any ODA Foundation scholarship awards you have previously received
Additional Honors and Awards: Please list any related to college and dental school
Curriculum Vitae or Resume
Upload your current Curriculum Vitae/Resume in PDF format. *

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Student Financial Information
Did you file a 1040 tax form in 2025?*

Yes (you must include a copy of your 2025 1040 with social security numbers redacted)No (you are not required to submit a 2025 1040)
Marital Status*

SingleMarriedDivorcedSeparatedWidowed
Do you have child dependents?*

YesNo
Number of child dependents:
Do you have any non-child dependents?*

YesNo
Please explain if you have non-child dependents:
Student's Adjusted Gross Income 2025 (don't include $ sign)*
Spouse's Adjusted Gross Income 2025 (if married) (don't include $ sign)
Student's (& Spouse's if married) current net worth (don't include $ sign)*
If you filed 2025 taxes, upload your 1040. Make sure to redact/black out your social security number. File must be a PDF.

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Applicant Essays

Two essay documents are required--the Student Financial Sketch and the Student Biographical Sketch. Each should be uploaded as a PDF document. Questions for these essays are detailed in the ODA Foundation Dental Student Scholarship Application Guidance document.
Student Financial Sketch
Upload your Student Financial Sketch Essays. Required essays are listed on the ODA Foundation Dental Student Scholarship Application Guidance. Please type the question before each answer. File must be a PDF. *

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Student Biographical Sketch
Upload your Student Biographical Sketch Essays. Required essays are listed on the ODA Foundation Dental Student Scholarship Application Guidance. Please type the question before each answer. File must be a PDF. *

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OPTIONAL: Dr. James F. Mercer Leadership Scholarship

If you would like to be considered for the Dr. James F. Mercer Leadership Scholarship and meet the qualifications, please submit the supplemental Mercer Leadership Essays as detailed in the Dental Student Scholarship Application Guidance. Students who will be a D4 dental student at the Ohio State University in Fall 2026, have a minimum 3.5 GPA at the end of their D3 year, and have been an Ohio resident for 5 or more years qualify for this special scholarship. Uploaded file must be in PDF format.
Intent to apply for the Dr. James F. Mercer Leadership Scholarship:

I meet the qualifications of the Dr. James F. Mercer Leadership Scholarship (D4 dental student at Ohio State in Fall 2026, minimum 3.5 GPA at the end of D3 year and an Ohio resident for 5 or more years) and would like to be considered for this special scholarship. I will upload my supplemental Mercer Leadership Essays below.
Upload your Mercer Leadership Essays. Essays are listed on the ODA Foundation Dental Student Scholarship Application Guidance. Please type the question before each answer. File must be a PDF.

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References and Letters of Recommendation

The ODA Foundation requires two letters of recommendation. One letter must be from an ODA member dentist (such as a mentor, childhood/family dentist, dentist from shadowing experiences or volunteer activities, or faculty member). The second letter should either be from a second ODA member dentist or a non-dentist member of the applicant’s community who can speak toward the applicant’s community involvement, leadership or advocacy experiences (such as a community leader, current or former employer, mentors, etc). Only one letter of recommendation can be from a dental school faculty member. Family members cannot provide letters of recommendation. Each letter of recommendation should be on the reference's professional or business letterhead and be signed (electronic signature is fine) and sent to the applicant as a PDF OR emailed directly to the ODA Foundation at cassy@oda.org. Uploaded files must be in PDF format.
ODA member reference
ODA member dentist's name (first and last) *
What is your relationship to this reference? *
Letter of recommendation will be:*

Uploaded below as part of the applicationEmailed from my reference directly to mollie@oda.org by the application deadline
Upload your ODA member letter of recommendation. File must be a PDF. If your reference will be emailing their letter of recommendation to cassy@oda.org, please upload a placeholder document that only states the reference's name and save it as a PDF.

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Community Member or Second ODA member reference
Reference's Name (first and last)*
What is your relationship to this reference?*
Letter of recommendation will be:*

Uploaded below as part of the applicationEmailed from my reference directly to mollie@oda.org by the application deadline
Upload your second letter of recommendation. File must be a PDF. If your reference will be emailing their letter of recommendation to cassy@oda.org, please upload a placeholder document that only states the reference's name and save it as a PDF.

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University Required Forms

Two forms from the ODA Foundation Dental Student Scholarship Application Guidance are required to be completed by representatives of your university/dental school. The Financial Needs Assessment must be completed by your dental school financial aid advisor and uploaded as a PDF. The Academic Achievement Record must be completed by your university's registrar or financial aid office and uploaded as a PDF.
Financial Needs Assessment
Upload your Financial Needs Assessment. File must be a PDF. *

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Academic Achievement Record
Upload your Academic Achievement. File must be a PDF. *

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Applicant Statement and Signature
I hereby affirm that all of the information supplied by myself and representatives of the university is correct and that I am an Ohio resident currently enrolled in an accredited dental program. I understand that misrepresentation, fraud or omission of facts is cause for disqualification or suspension of a scholarship.
Applicant's Signature*

Clear
Name of Applicant*

First NameLast Name
Date Signed by Applicant*

MonthDayYear
Date
Should be Empty:

Dental Student Scholarship

Applicant Information

Educational Information

ASDA Involvement

Scholarships, Honors and Awards

Curriculum Vitae or Resume

Student Financial Information

Applicant Essays

Student Financial Sketch

Student Biographical Sketch

OPTIONAL: Dr. James F. Mercer Leadership Scholarship

References and Letters of Recommendation

ODA member reference

Community Member or Second ODA member reference

University Required Forms

Financial Needs Assessment

Academic Achievement Record

Applicant Statement and Signature