WDHA Lifelong Learning Grant Application

WDHA may award Lifelong Learning Grants each year as budget allows to:

  • One Association member who is enrolled in a Washington State bachelor degree program in dental hygiene or a related field, and
  • One Association member who is enrolled in a graduate degree program in dental hygiene or a related field

The grant may be presented to each recipient at the House of Delegates.  Grant criteria based on demonstration of financial need will be established by financial documentation with application. Applications must be received at Central Office no later than 4 pm on the first Friday in August. The 2019 deadline is August 2nd.


First Name
Last Name
Mailing Address
Contact Phone #
ADHA ID Number
Which Dental Hygiene Program are you attending?
Year of Graduation
Washington State Credential Number
How long have you practiced dental hygiene?

Scholastic Information


List all the schools you have attended post high school, with your GPA

Family Information


Marital Status
Number of Dependents
Are other family members attending a college for which you are helping to finance?
If yes, what is the total amount you contribute annually?

Please answer the following questions:


Financial Information

What is your current plan to finance your advanced education? Include financial total from each planned source. Include anything you feel is important on this issue.
Have you been the recipient of any scholarships, awards, grants, financial aid or educational loans? Please list name, amount and if it will continue next year.
Please identify any other financial aid for which you are applying to assist you in financing.
What was your reported gross income for the most recent tax year?

Personal and Professional Goals

Please submit (copy and paste) a brief essay that addresses the following:

A. Describe how you think an advanced degree will enhance your career in dental hygiene.

B. Describe how you have been active in your association and what you consider to be the importance of membership in your professional life.

C. Describe your volunteer work and community service.

Please provide 2 letters of reference with your application. One must be from a dental hygiene instructor. Letters can be uploaded with online application, emailed to wsdha@comcast.net, or mailed to PO Box 389, Lynnwood, WA 98046. Letters must be postmarked by 8/2/19.

Upload your reference letter 1
Upload your reference letter 2
Are you attending this year's House of Delegates?
The grant will be sent directly to the institution of higher learning you are enrolled in. Please indicate the name, address and department this should be directed to if you are selected as a grant recipient:
Please type your full name below for your signature.

Deadline for Application: August 2, 2019

Only online applications will be accepted.


Before submitting this form, please click on the link below to move the contents of box "A" into box "B" leaving the first box empty.

A: B: Click to Move