To be eligible, you must be a senior, a past or present Molen Orthodontics patient and fill out the form below. Please submit this form with your video or full page essay submission to your scholarship specialist at your school. Your scholarship specialist will forward all submissions to Molen Orthodontics. It is the responsibility of the scholarship applicant to ensure that he or she has obtained permission from all parties featured in their video with signatures below.

The essay prompt is: There is Power in Every Smile! Everywhere you go, your smile goes with you. Please record a 1 to 2 minute video (preferred option) or write a full page essay describing how your smile has impacted your life or another’s in a positive way.  A smile is powerful and can change your life and change the world. What will you change? Have fun and be creative!