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* 1. Are you a current D3 student enrolled in the third year of an accredited four-year traditional pre-doctorate dental program in Illinois?

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* 2. What is your full name?

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* 3. Your address:

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* 4. Phone number: 

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* 5. E-mail: 

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* 6. Your Dental School

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* 7. Write an essay of no more than 500 words that addresses the following questions: Realizing that you are still a D3 but looking ahead to including your D4 year, what do you feel has been the strongest part(s) of your school's curriculum to best prepare you for dentistry after graduation? Conversely, what parts could have been more emphasized and other areas less emphasized to make you a more well-rounded, better prepared and well-informed dentist?
(Fill this out in the comment box provided. You may also copy and paste it within this box)

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* 8. You must upload a signed statement from your dental school administration guaranteeing your academic status with your University/Student in good standing form. (a sample file is available on the ISDS Foundation's Scholarship web page)

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