Dental Application

Application Form for the Dental Hygiene Program

Class Entering Fall 2024

Telephone Number: (Only One is Required)

Mailing Address:

If transferring, please complete the following information:

Please select any of the classes or their equivalent listed below that you will be taking or retaking during the Fall 2023 or Spring 2024 semesters for consideration for the Dental Hygiene Program:
Have you completed all of the Allegany College of Maryland Admissions requirements including application for admission:
     (You must also file a regular college application)

I certify that all the statements given on this application are true and accurate to the best of my knowledge.

I also certify that it is my responsibility to notify the Dental Hygiene Department of any changes in address, phone number(s) and email addresses that may occur after the submission of this application.

I further acknowledge that the Dental Hygiene Department will communicate with me using the information provided on this application. The Dental Hygiene Department will not be responsible for my failure to receive important communications and respond to them in a timely manner, as a result of the department having inaccurate contact information.

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