Please complete your scholarship application by completing the information below and attaching your transcript. If you have any questions, please contact scholarships@imagendentalpartners.com

By submitting this scholarship form, I acknowledge that I hereby grant Imagen Dental Partners, Inc. and Concorde Career Colleges, Inc. and it's affiliates and representatives’ permission or authority to use my name, information and likeness as it pertains to promoting and recognizing any award granted me as it relates to this scholarship offering. I further make no claim and forever release, discharge and agree to save harmless Concorde and all persons acting under its permission or authority, from and against any and all claims, liabilities, costs, damages and obligations arising from the use of my likeness, voice and/or name as it pertains to my enrollment in Concorde and participation in this scholarship competition.