Faculty evaluation
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Please state the FIRST and LAST name of the student you are completing the application for. *
Please state your First and Last name. *
What School is the student attending? *
Is the student a citizen of the United States? *
Has the student completed a minimum of one year in an accredited dental hygiene school? *
State the student’s dental hygiene grade point average on a 4.0 scale. *
State your familiarity with the candidate.  How long have you known the student and how well? *
Financial need - Rate the candidate as to his/her financial need based on your information. *
Least financial need
Most financial need
Leadership Qualifications - Rate the candidate as to his/her leadership capabilities: i.e., ability to inspire confidence, self-confidence, deliberation, decisiveness, member of organizations, and officer in any organizations, awards received for outstanding achievement, etc.
Least leadership qualifications
Most leadership qualifications
Clear selection
Comment on the candidate’s goals as they compare to his/her level of maturity and achievement. *
OPTIONAL- Additional Comments and Recommendations - Please submit any additional information you believe would be helpful to the Scholarship Committee.
Please type your name to signify that you have completed this form to the best of your ability. *
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