Dental Assisting & Dental Hygiene Application

Student Information

First Name

Last Name

Middle Initial

Student ID

Address

Street Name

City

ZIP/Postal Code

Contact

Daytime Phone Number

Evening Phone Number

Enter your VCCS Email

Resident County

Other Information

Please consider my application for admission for the following:

Dental Hygiene

Dental Assisting

Both programs

I have completed or will complete my TEAS test on the following date:

How to prep for the TEAS test

Schedule your TEAS test

Indicate which other documents you're including in your application. This documentation is optional for Dental Assisting applicants.

Certificate of Dental Assisting issued by Dental Assisting National Board

Work Experience Form

Dental Professional/Office Observation Form

Volunteer/Civic Engagement Documentation Form

Upload Documents

Maximum 4 files.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Essay Question

500 words or less

What does it mean to you to be an allied dental professional? Describe how your temperament/personality and life experiences have prepared you to be an excellent oral health care student.

Verification Code & SIgnature

Germanna Community College students pursue academics with honesty, integrity, and respect for themselves, fellow students, and the College community. I certify that this application is true and accurate to the best of my knowledge. I have not received any assistance in the completion of this application and all thoughts reflected in the essay question are my own. Appropriate citations are made when ideas from other sources are used.

Your signature is required. Please reenter your full name.

Enter the application information session certification code:

I acknowledge that I am responsible for submitting all all transcripts, transcript evaluations, and supporting documents prior to the end of the application period.

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