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SAMPLE DENTAL
HYGIENE APPLICATION
This is last year’s application. It is available to help you plan for your
admission to the NAU Dental Hygiene Program.
2014
DENTAL HYGIENE PROGRAM
APPLICATION PACKET
Students interested in the Dental Hygiene Program are encouraged to contact the
Dental Hygiene Department advisor with any questions that remain after reading
the entire packet. The Dental Hygiene Advisor is Eric Pawelski. He can be reached
at 928-523-5985 or at [email protected]. This packet is updated annually and
additional information is available on our website.
Northern Arizona University
Dental Hygiene Department
Phone: 928-523-5122
Physical Address:
208 Pine Knoll Dr
Building #66 Room 215
Flagstaff, AZ 86011
Mailing Address:
Po Box 15065
Flagstaff, AZ 86011
1
Guide to the Northern Arizona University Dental Hygiene Application Process
****IMPORTANT- PLEASE READ BEFORE COMPLETING THE APPLICATION****
The following materials are included in this application packet:
Cover Sheet
Application Guide
Application Checklist
Program Information:
 General Information
 Application Process
 Method of Selection
 Bloodborne Pathogen Statement
 Once Admitted to the Program
 Criminal Background Check
 Non-Discrimination Policy
 Complaints
Dental Hygiene Admissions Process
Degree Progression Plan
Dental Hygiene Estimated Fees
Dental Hygiene Application
Page 1
Page 2
Page 3
Pages 4-8
Page 9
Pages 10-11
Page12
Page 13
All applications and required forms must be completed and received by the NAU Dental
Hygiene Department no later than January 31 of the year student is seeking admittance. Due to
the volume of applications, any application received after January 31 will only be reviewed on a
space available basis.
Completion of the NAU Dental Hygiene Program application process by the deadline is the sole
responsibility of the applicant. Meeting deadlines and completing application information forms
properly demonstrates the ability, maturity, and self-motivation desired in NAU Dental Hygiene
students.
Return all required NAU Dental Hygiene Program applications, transcripts, and all other
requested materials to:
NAU Department of Dental Hygiene
Attention: Selection Committee
PO Box 15065
Flagstaff, AZ 86011-5055
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NAU DENTAL HYGIENE PROGRAM
APPLICATION CHECKLIST
Prior to review by the admissions committee, the following must be submitted:
Official transcripts for all colleges attended*
Catalog descriptions for all prerequisites taken out of state or at private schools.
Dental Hygiene program application
Self-Addressed envelope for acceptance or denial letter
*Non-official transcripts should be sent for all coursework completed at NAU.
AGEC students must mark this status on prerequisite material.
All information must be included in admissions file to be considered complete. Any piece of
documentation missing will result in the applicant not being considered for admission.
Information will not be accepted via fax or email. It must be delivered in person or through the
mail by the application deadline in an envelope. Please notify us of any change in address as
soon as possible. It is the responsibility of each applicant to ensure that the application is
complete and that all information is on file.
YOU SHOULD RETAIN COPIES OF THE APPLICATION YOU SUBMIT.
If you reapply in the future, information will not be released from any previous applications.
You will be required to fill out a new application and accompanying documents for each year
you apply.
You will be notified by mail or email of your acceptance or denial into the
program. No information will be given regarding an applicant’s admission
status over the phone.
DO NOT CALL the Department of Dental Hygiene to obtain your status as this
slows down the admissions process. If you would like to see if your application was
received send an email to [email protected] with the subject line reading:
Application Received.
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PROGRAM INFORMATION
The NAU Dental Hygiene Program is accredited by the American Dental
Association Commission on Accreditation.
GENERAL INFORMATION:
The Dental Hygiene Program is a 2-year program consisting of four 16 week semesters with a
five week summer term followed by a two week externship which is completed before classes
start in the fall. Classes are only offered through the Flagstaff Mountain Campus. Graduating
students will receive a Bachelor of Science Degree in Dental Hygiene.
Students are required to learn and practice clinical skills on each other throughout the program.
This means that all students must participate as both a student clinician and as a patient. The
procedures students will be preforming and being subjected to include:
 Reviewing medical and dental histories
 Taking vital signs
 Practicing instrumentation
 Giving oral local anesthetic injections
 Placing sealants when indicated
 Taking Radiographs
As part of the dental hygiene curriculum student are required to complete several rotations
throughout the program. Some of these rotations will require the student to be gone for several
days or longer. The NAU Dental Hygiene Department does provide faculty supervised housing
and transportation for the Hopi rotation located in Pollaca, AZ approximately 2.5 hours away
from the Flagstaff area. The student may choose to drive to and from the location; however, the
student will then be responsible for getting themselves to the Hopi Clinic on time each day and
provide their own transportation. Students are expected to drive to the Yavapai Clinic and
return in the evening of the same day using their own transportation. They may arrange to
carpool with other students.
Students also go on summer externships to Guatemala, Peru, Hawaii, Phoenix, San Diego,
Prescott, Flagstaff, and various other locations. Externships are an exciting opportunity to put in
to practice what has been learned. They are a time of tremendous growth for our students. When
applicants come for their interview they should use that time to speak with our current students
and view their presentation materials on different externships.
4
APPLICATION PROCESS
The Dental Hygiene program at NAU adheres to a 2+2 curriculum, where four terms of
prerequisite course work are combined with five terms of dental hygiene coursework at NAU.
Students must have completed (or be in the process of completing) 51 units of coursework prior
to applying to the program. The program’s prerequisites are listed in the degree progression
plan as the courses to be taken during the first 2 years.
Students must have a minimum 2.50 GPA at the time of applying and maintain this GPA until
the start of the program. Attaining the minimum requirements for entry does not guarantee a
seat in the class.
Successfully completed college level courses taken before entry will be considered as
fulfillment of the core course requirements if taken within 10 years prior, with the exception of
science courses, to admission to the dental hygiene program. All science courses taken more
than five years ago must be retaken.
METHOD OF SELECTION:
Criteria for selection are weighted. Points will be awarded to applicants based on GPA of
successfully completed college coursework. Points will also be awarded for their
communication skills, professional demeanor, writing skills, work experience, community
service, and military service.
The NAU Dental Hygiene Program is the only Bachelors of Science in Dental Hygiene
Program in the State of Arizona. Students that apply should be aware and understand the
following:
1. Admission to the Dental Hygiene program is selective. It is NAU’s goal to prepare
graduates to become highly competent hygienists and who exhibit high standards of
professionalism with patients. In order to achieve our program goals, admission criteria
has been established to evaluate applicants as to their suitability.
2. Since there are more applicants than available space, admission is competitive. Meeting
the minimum criteria merely allows you to submit an application and is not a guarantee
of acceptance into the dental hygiene program. Students who are not admitted must
reapply each year. Alternate status does not guarantee a position in the next class to be
admitted.
3. Interviewees will be required to submit an essay completed on the day of their interview.
The essay will be less than one page and typed in the presence of a faculty member. The
topics will be given out the day of the interview. We are looking for college level
grammar, spelling, and sentence structure.
4. Alternate Status: Alternates will be ranked according to admission criteria. If an accepted
student chooses not to take their place in the program the alternates will be notified by
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ranking until the place is filled. Alternates will be considered for open positions until
August 1st of each year.
5. A student who withdraws from the program for whatever reason must apply for
readmission. The student applying for readmission is NOT guaranteed a position in the
next entering class. Except for the most extenuating circumstances, the student can apply
for readmission only once.
Upon the successful completion of the Dental Hygiene Program with a GPA of 2.5 or better, the
student will be awarded a Bachelor’s Degree in Dental Hygiene. The student must also take the
National Board Dental Hygiene Examination, the State/Regional Board and apply for licensure
in the state where she/he will want to practice. Graduation from the Dental Hygiene program
and receipt of the degree does not guarantee the student will successfully pass the National
Board and/or state/regional board.
BLOOD BORNE PATHOGEN STATEMENT
All applicants must be aware that the activities required for both the Northern Arizona
University Dental Hygiene Program and the profession of dental hygiene, require the
student/professional to participate in procedures that place the clinician at risk for exposure to
blood borne pathogens.
ONCE ADMITTED TO THE PROGRAM YOU WILL NEED:
 Immunizations-must be completed prior to the first day of classes.
o Hepatitis B (Hepatitis A vaccination may be required)
o MMR
o Varicella
o TDAP
o PPD (required yearly)
o Flu Vaccine may be required
 Current Eye Prescription
 Proof of Health Insurance
 Proof of Automobile Insurance and a Valid Driver’s License
 CPR certification required yearly
 Current Physical
 Liability Insurance
 Finger Print Clearance
CRIMINAL BACKGROUND CHECK
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Criminal background checks are required for NAU Dental Hygiene students. A felony
conviction may impact eligibility to obtain a dental hygiene license and work as a dental
hygienist.
NON-DISCRIMINATION POLICY
There are no restrictions placed on applicants because of their color, creed, race, religion, sex,
marital status, or national origin.
COMPLAINTS FILED WITH THE AMERICAN DENTAL ASSOCIATION
COMMISSION ON DENTAL ACCREDITATION
Students, faculty, constituent dental societies, state boards of dentistry, and other interested
parties have the right to file a complaint with the American Dental Association Commission on
Accreditation. To file a complaint write to the Commission at the address below. A copy of the
appropriate accreditation standards and/or the Commission's policy and procedure for
submission of complaints may be obtained by contacting the Commission at 211 East Chicago
Avenue, Chicago, IL 60611-2678 or by calling 1-800-621-8099 extension 4653. Only written,
signed complaints will be considered by the Commission; oral and unsigned complaints will not
be considered. A complaint is defined by the Commission on Dental Accreditation as one
alleging that a Commission-accredited educational program or a program which has an
application for initial accreditation pending, may not be in substantial compliance with
Commission standards or required accreditation procedures. The Commission on Dental
Accreditation will review complaints that relate to a program's compliance with the
accreditation standards. Students, faculty, constituent dental societies, state boards of dentistry,
and other interested parties may submit an appropriate, signed complaint to the Commission on
Dental Accreditation (CDA) regarding any CDA-accredited dental, allied dental or advanced
dental education program, or a program which has an application for initial accreditation
pending. The Commission is interested in the sustained quality and continued improvement of
dental and dental-related education programs, but does not intervene on behalf of individuals or
act as a court of appeal for treatment received by patients or individuals in matters of admission,
appointment, promotion or dismissal of faculty, staff or students.
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DENTAL HYGIENE ADMISSIONS PROCESS
Application /Admissions Process:
1. The student must apply to Northern Arizona University declaring Dental
Hygiene as their major. Please see our advisor for questions.
2. Students can download the application packet through the NAU Dental
Hygiene website. Applications will only be accepted January 1st through 31st
of the year you are seeking admittance. Please make sure you have the
current application marked by the year you are applying.
3. Have all official transcripts included in your NAU Dental Hygiene
Application. AGEC students must mark that on prerequisite material. NAU
students must send unofficial transcripts to the Department.
4. Top candidates will be invited to interview with the selection committee.
Interview dates are February 21 and 22, 2014.
5. Students will be notified of their acceptance or their denial into the program
by mail or email. Students are typically notified the middle of March. Those
students accepted will be asked to submit an acceptance card and make a
$500.00 non-refundable deposit to the Dental Hygiene Program Department
by the specified deadline.
8
Bachelor of Science Dental Hygiene Degree Progression Plan
Freshman Year
DH 102
BIO 181
CHM 130
CHM 130L or
CHM 151L
STA 270
1st Term
DH Orientation
Unity of Life I (SCI:SAS)
Fundamental Chemistry (SCI:SAS)
Fundamental Chemistry Lab (SCI:LAB) or
General Chemistry I Lab (SCI:LAB)
Applied Statistics (FNRQ)
1
3
3
1
BIO 201
BIO 201L
ENG 105
NTS 135 or
NTS 256
PSY 101
3
11
Total
2nd Term
Human Anatomy/Physiology I (SCI:SAS)
Human Anatomy/Phys I Lab
Critical Reading & Writing (FNRQ)
Applied Nutrition & Food Selection or Medical
Nutrition
Intro to Psychology (SPW)
Total
3
1
4
3
3
14
Sophomore Year
BIO 202
BIO 202L
BIO 205
BIO 205L
SOC 101
LS
3rd Term
Human Anatomy/Physiology II
Human Anatomy/Physiology II Lab
Microbiology
Microbiology Lab
Introduction to Sociology (SPW)
Liberal Studies CU/ Diversity
Total
3
1
3
1
3
3
14
BIO 320
LS
LS
LS
4th Term
General Pathology
Liberal Studies AHI/ Diversity
Liberal Studies AHI/ Diversity
CU/ Diversity
3
3
3
3
Total
12
Total
3
5
3
3
1
3
17
At this point students must be accepted into the Dental Hygiene Program
Junior Year
DH 302
DH 306
DH 311
DH 338
DH 370
DH 372
5th Term
Head & Neck, Oral & Dental Anatomy
Oral Histology & Embryology
Pre-Clinic
Oral Radiology
Professionalism
Oral Health & Disease Prevention
Total
3
2
5
3
1
3
17
DH 300
DH 312
DH 316
DH 369
DH 371
DH 373W
6th Term
Oral Medicine & Pharmacology I
Clinic I
Periodontics I
Oral Pain Management
Communication & Behavior
Assessment & Program Planning
Junior Summer
7th Term
DH 313
Clinic II: Patients
2
DH 340
Oral Pathology & Radiographic Interpretation
3
DH 408
Public Health Externship
2
Total
7
Senior Year
DH 409
DH 410
DH 411
DH 419
DH 451
DH 474
8th Term
Cariology, Restorative & Dental Materials I
Oral Medicine & Pharmacology II
Clinic III Advanced Procedures
Periodontics II
Research Seminar
Program Implementation
9th Term
Total
Liberal Studies
Distribution
Blocks
AHI
Counted above
Counted above
2
3
6
3
2
1
17
DH 412
DH 413
DH 416
DH 475
DH 495C
Clinic IV: Outreach
Cariology, Restorative & Dental Materials II
Career Management
Program Evaluation
Capstone–Oral Health Outcomes
5
2
2
1
3
Total
CU
Counted above
Counted above
9
SPW
PSY 101
SOC 101
SCI
BIO 181
CHM 130, 130L or 151L
Other
BIO 201
13
This four year plan is to be used in conjunction with the academic catalog and degree progress report. 
 Students should see an academic advisory regularly to confirm their academic progress.
 Students must see an academic advisor before enrollment for the 6th term in preparation for graduation.
 Honors students complete different requirements to meet NAU’s liberal studies program. Students should consult
an Honors Program advisor for fulfilling Honors Liberal Studies requirements.
 AGEC students must mark that status clearly on all prerequisite materials.
GENERAL INFORMATION
 This degree progression plan is to be used in conjunction with the academic catalog and degree progress
report.
• Students are encouraged to see an academic advisor regularly to confirm their academic progress.
• Many courses have pre-requisites. Please check the academic catalog for pre-requisite and placement
information. http://www4.nau.edu/academiccatalog/2005/academiccatalog.htm
• Some courses are only offered once a year (Fall term only or Spring term only). Some of these courses may be
pre-requisites for future courses. Please check with your advisor for current course rotations.
• Honors students complete different requirements to meet NAU's liberal studies program. Students should
consult an Honors Program advisor for complete information on fulfilling Honors Liberal Studies
requirements.
• All students are required to complete a minimum of 123 total units which includes:
 35 units of liberal studies courses: http://www4.nau.edu/aio/LScourselist.htm
 6 units of diversity courses: (3 units in Global and 3 units in Ethnic):
http://www4.nau.edu/aio/DiversityCourseList.htm
• Enrollment in the English foundations course for liberal studies is based off of student SAT/ACT scores or
incoming transfer/test credit, otherwise the student must take the English Placement Exam:
http://testing.nau.edu/exams/placement.html
• Enrollment in the Math foundations course for liberal studies requires students to take the ALEKS Math
Placement Exam:
http://www.cefns.nau.edu/Academic/Math/studentInformation/Placement/Placement.shtml
CONTACT INFORMATION
Eric Pawelski
Dental Hygiene Academic Advisor
College of Health & Human Services
PO Box 15015
Flagstaff, AZ 86011
[email protected]
Phone: (928) 523-5985 Fax: (928) 523-3600
Courtney Blakesley
Administrative Assistant, Dental Hygiene
College of Health and Human Services, Building # 66, Room 215
PO Box 15065
Flagstaff, AZ 86011
[email protected]
Phone: (928) 523-5122 Fax: (928) 523-6195
10
DENTAL HYGIENE DEPARTMENT ESTIMATED FEE SCHEDULE
One Time Fees
Name Badge
Scrubs*
Shoes*
Liability Insurance* (2 yr policy)
Fingerprint Clearance*
Immunizations*
First Aid*
DH 102 Orientation
$12.00
$80.00
$50.00 *Paid to outside vendors
$180.00 **Some books will be used all 5
$75.00 semesters of the program
varies
$25.00
$40.00
$462.00
Junior Year
Supplies
Instrument Kits*
SADHA
Radiology Badge
Lexicomp
E-Value
Program Fees
Class Fees
Transportation *
WREB Anesthesia *
Tuition(in-state)
CPR Certification*
Books**
Senior Year
$250.00
$3,649.97
$65.00
$15.00
$33.50
$100.00
$800.00
$1,070.00
$200.00
$375.00
$6,435.00
$50.00
$900.00
$13,943.47
Supplies
$350.00
Instrument Kits
$370.71
SADHA
$65.00
Radiology Badge
$15.00
Lexicomp
$33.50
E-Value
$100.00
Program Fees
$800.00
Class Fees
$780.00
Books
$600.00
Tuition (in-state)
$4,290.00
Transportation
$200.00
CPR Certification*
$50.00
TB Test
$30.00
WREB
$1,500.00
Local Anesthesia Board Exam
$375.00
$9,559.21
Please note these are estimated expenses. They are subject to change. Fees
are the student's responsibility and are expected to be paid on time or a
penalty will be assessed such as losing clinic access.
11
COLLEGE OF HEALTH & HUMAN SERVICES
BACHELOR OF SCIENCE IN DENTAL HYGIENE
Deadline for Applying is January 31st.
Applications received after January 31st will be considered on a space available
basis. Every data field must be completed and legible for the application to be
considered valid. Click on the gray boxes to enter your information. The completed
form must be signed and mailed in. Handwritten forms (other than the signature
box) will not be accepted. Thank you for your cooperation.
DATE
NAME
DATE OF BIRTH
STUDENT ID NUMBER
ADDRESS
PHONE
EMAIL ADDRESS
PHYSICIAN
DENTIST
EMERGENCY CONTACT NAME
PHONE
RELATIONSHIP
The following page contains your application committee score card. Please fill
out all gray information boxes using a size 12 font. The Department will verify
this information, average your GPA, and assign points.
12
APPLICATION COMMITTEE SCORECARD
APPLICANT ID:
Prerequisite
(Please write in Transfer Course
Equivalent if applicable)
NAU ID:
Letter Grade
AGEC
IP=In Progress
Institution
BIO 181
CHM 130
CHM 130L
NTS 135 OR 256
BIO 201
BIO 201L
BIO 202
BIO 202L
BIO 205
BIO 205L
BIO 320
SCIENCE GPA =
To Be Calculated by the Department
DH 102
STA 270
PSY 101
SOC 101
ENG 101
ENG 102
ENG 105
LS/CU/DIV
LS/AHI
LS/AHI
CU/DIVERSITY
CUMULATIVE GPA =
To Be Calculated by the Department
Totals
Below to be filled out by the Department ONLY
# of Courses Completed __x 4.545= ___ x .4=
Science GPA ____x 25 = __ x .2=
Cumulative GPA ___ x 25 = ___ x .1 =
Interview Score ___ x 4 = ___ x .2=
Essay Score ___x 25 = ___ x .1=
BONUS (Professional Judgment Points)
Total Points
13
Previous Education: (high school and/or college)
School
City/State
Diploma/Degree
Dates
Professional Judgment Points
Are you fluent in a foreign language?
If so, please list language.
Military Service?
Dental Assisting Background?
Accredited Program
Graduated from:
Non-Accredited Program
On the Job Training
Please List the Program if Applicable
Community Service? Please Include Details.
Official Transcripts (unofficial for NAU, AGEC status marked)
Catalog descriptions (for all courses taken at private schools or out of state)
I have read and understood all materials accompanying this application.
Student Signature
Date
Mail completed application and all required materials to:
NAU Dental Hygiene Department
Attention: Selection Committee
PO Box 15065
Flagstaff, AZ 86011
14