MARTHA E. HENCKE SCHOLARSHIP

Greater Fort Worth Dental Hygienists' Association
www.GFWDHA.org

Dear Dental Hygiene Students,
The Greater Fort Worth Dental Hygienists' Association (GFWDHA) is accepting applications for the Martha E. Hencke Memorial Scholarship. In the past, this scholarship was offered only to second year dental hygiene students at TCC Northeast Campus. However, we have recently opened the application to ALL students at TCC who are registered in the first or second year of dental hygiene studies. Furthermore, we are accepting applications from students enrolled in de-gree completion or advance degree studies in dental hygiene or the sciences. This scholarship is offered to help meet educational and licensure expenses of a student deserving of this additional financial support. We are pleased to award a $500 scholarship to a student who exemplifies both academic and leadership qualities.

Our Association has established a committee to review all applications. The scholarship will be awarded on the basis of financial need, verification of passing academic grade point average, and faculty evaluation and recommendation. All forms should be mailed to the address below no lat-er than the December 1 deadline. The scholarship will be awarded at the SCADHA meeting in January or February. Also, please be aware that if the recipient of the award does not complete the program for any reason, the recipient will be expected to repay all monies received to the Greater Fort Worth Dental Hygiene Association.

If you would like to apply for this scholarship, please proceed carefully and thoughtfully through the following steps:
1 Fully complete the student portion of the application.
2. Attach a copy of your transcript and/or latest report card.
3. Write your name at the top of the "Faculty Evaluation Form".
4. Give the Faculty Evaluation Form to three dental hygiene instructors (make 2copies of form) of your choice. One of these instructors must be a full-time dental hygiene program instructor. Request a time/date that you can pick up the completed evaluation forms from the dental hygiene faculty members. Each must be sealed in an envelope with the Faculty member’s signature across the seal.
5. Obtain two letters of recommendation. Each letter may be from a fellow SCADHA member, a non-hygiene faculty member, a clergy, friend, or family member. The letter should be brief - lim-ited to one page - and should state why the person thinks you deserve the scholarship.
6. Secure all forms, including sealed faculty evaluation forms, in an envelope and mail no later than December 1.

Kathy Navarro
3804 Treemont circle, Colleyville, TX 76034
Greater Fort Worth Dental Hygienists' Association
www.GFWDHA.org
All applications become the property of GFWDHA and will not be returned to the individual applicant.


Downloadable Form: Instructions and Application

MARTHA E. HENCKE SCHOLARSHIP
APPLICATION STUDENT BIOGRAPHICAL FORM

NAME

ADDRESS

PHONE

DATE

Please answer the questions below as completely as possible. Use the back of the paper or attach a separate page if necessary. Applications that are not complete or are received past the deadline will not be considered.

I. a) How is your education being funded? (self, grants, loans, other scholarships)




b) Are you currently employed? If so, how many hours per week do you work? State the place of employment.





c) Do you have responsibilities that demand your time and/or money besides school? (family, church, or other organizations)





II. Do you earn money for school with summer employment?





III. List and explain academic achievements and positions in which you have demonstrated leadership. (scholarships, special awards, Dean's List, offices held, volunteer work)





IV. Briefly state your plans for further enrichment to the profession of dental hygiene upon graduation.





Greater Fort Worth Dental Hygienists' Association

MARTHA E. HENCKE SCHOLARSHIP APPLICATION
FACULTY EVALUATION FORM

STUDENT NAME:

On a scale of 1-5, with 5 being the highest:
Clinical appearance 5 4 3 2 1
Punctuality 5 4 3 2 1
Professionalism 5 4 3 2 1
Rapport with patients 5 4 3 2 1
Consideration of peers 5 4 3 2 1
Rapport with faculty 5 4 3 2 1
Problem solving abilities 5 4 3 2 1
General attitude 5 4 3 2 1
Please comment on the student's leadership qualifications, ability to achieve personal goals, and any additional qualities that you feel are relevant to this scholarship.



Date

Signature