2025 ADEA GoDental Recruitment Event Travel Assistance Form

Student Full Name:*

First NameLast Name

Your Institution:*

Your Mailing Address Where Funds Will Be Sent:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student E-mail:*

Confirmation Emailexample@example.com

Student ID#:

Financial Aid Officer Full Name:*

First NameLast Name

Financial Aid Officer E-mail:*

Confirmation Emailexample@example.com

Upload completed form with Financial Aid Officer's signature.

Financial Aid Office:

The 2023 ADEA GoDental Recruitment Event is an annual event sponsored by the American Dental Education Association (ADEA) for prospective dental students who are interested in applying to dental school. This event (to be held in Portland, OR on March 11, 2023) provides approximately 700 students the opportunity to talk one-on-one with over 55 dental schools. Each year, ADEA offers financial assistance to a limited number of students who travel a distance greater than 50 miles to attend the event. To be considered for this program, students must:

Be currently enrolled in an undergraduate program,
Be a U.S. citizen or permanent resident,
Have documented DACA (Deferred Action for Childhood Arrivals) status and
Demonstrate financial need.

The student submitting this form is requesting to be considered for the ADEA Travel Assistance Program and must provide verification that they demonstrate financial need.

Is this student a Pell Grant Recipient?

YesNo

Is this student borrowing a Direct SUBSIDIZED loan?

YesNo

Is this student borrowing up to the full cost of attendance or financial aid budget?

YesNo

Did this student decline any financial aid offered, and if so what type(s) did they decline?

YesNo

If the student declined financial aid, please list what type(s) of financial were declined.

Student has verified DACA status?

YesNo

Optional comments:

Financial Aid Officer Full Name:

First NameLast Name

Financial Aid Officer Signature

Title:

Date (MM/DD/YYYY):

2025 ADEA GoDental Recruitment Event Travel Assistance Request Form

Applicant Information

Financial Aid Office