APPLICATION for Harding Predental Scholarship

Name _____________________________________________________________

Address _____________________________________________________________

Phone ______________________ Email Address_________________________

Education:

List all undergraduate colleges attended.

College name...................................... Dates Attended

______________________________________ ________________________

______________________________________ ________________________

______________________________________ ________________________

______________________________________ ________________________

List all graduate or postbaccalaureate colleges attended:

 College name................................................. Dates Attended

______________________________________ ________________________

______________________________________ ________________________

______________________________________ ________________________

______________________________________ ________________________

Science GPA _______ # of units _____ (From GPA Calculation Sheet)

Nonscience GPA ________ # of units _____ (From GPA Calculation Sheet)

Anticipated date of graduation __________ Major ________________________

What honors have you received while in college?

List all dental related activities in which you have participated during college.

In the space below, state concisely why you are interested in the dental profession and how you have tested that interest.

How do you think this scholarship program will benefit your career objectives?

Please attach a GPA Calculation Sheet Form to this application. (See "Useful Forms" on the PPHA Web Page.)

***