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James F. Mulick Educational Scholarship - 2023 Application

Established by ACPA Member Dianne Altuna in memory of her father James F. Mulick this scholarship supports the participation of orthodontists in ACPA’s Annual Meeting. The James F. Mulick Educational Scholarship provides one $2,500 award annually to be used toward meeting registration, travel, and lodging expenses related to ACPA’s Annual Meeting. The recipient also receives a one-year ACPA professional membership.

Preference is given to community US-based orthodontists. Orthodontic residents and fellows may also apply. Non-ACPA members and ACPA members are eligible to apply.

Applications are due Tuesday, November 15, 2022.

1. Applicant Information *This question is required.
2. Are you currently a member of the American Cleft Palate-Craniofacial Association (ACPA)? *This question is required.
3. Have you ever attended ACPA's Annual Meeting? *This question is required.
4. Current Education
  *This question is required.
5. Do you have any previous education? *This question is required.
Previous Education
Do you have any other previous education?
Previous Education
11. Please attach your resume or CV. *This question is required.
12. Please attach a letter of endorsement. *This question is required.
13. If you are a community orthodontist, attach proof of employment.
If you are a resident or fellow, attach a letter from the department chair confirming your status. *This question is required.
14. I verify that this application was completed accurately by the person named below. *This question is required.
Signature of