MADDUX ORTHODONTICS
PATIENT SCHOLARSHIP

Apply to earn money toward your college tuition!

Requirements to Apply for Maddux Orthodontics Patient Scholarship:

Applicant must be a senior in high school or a current college student.
Applicant must be a current or former patient of Maddux Orthodontics.
Applicant must fill out and submit the simple application form below.

Scholarship applications must be submitted by May 1 to be considered for the current school year; any applications received on May 2 or later will be applied to the following school year. A $1,000 scholarship will be given to one chosen scholarship winner.

Scholarship Application

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Email

This field is for validation purposes and should be left unchanged.

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Please list the schools you have attended the last four years*

What college/university do you attend/are you planning on attending?*

List your high school and current college activities. List in descending order of significance*

(student government, sports, publications, school-sponsored community service programs, clubs, honor societies, arts, music, etc.)

List your public service and community activities. Do not repeat items listed previously. List in descending order of significance.*

(homeless services, environmental protection/conservation, advocacy activities, work with religious organizations, etc.)

List awards, scholarships, publications or special recognitions you have received. List in descending order of significance*

Pick an experience from your own life and explain how it has influenced your development.*

Why do you want to get a college education?*

What additional personal information do you wish to share with us?*

MADDUX ORTHODONTICS PATIENT SCHOLARSHIP

Apply to earn money toward your college tuition!

Requirements to Apply for Maddux Orthodontics Patient Scholarship:

Scholarship Application

MADDUX ORTHODONTICS
PATIENT SCHOLARSHIP