DANVILLE COMMUNITY COLLEGE DENTAL ASSISTING JOB SHADOWING FORM APPLICANT’S NAME ____________________________________________________ DENTAL OFFICE _______________________________________________________ NUMBER OF HOURS COMPLETED ________________________________________ DATES OF SHADOWNING _______________________________________________ ___________________________________________________________________ SIGNATURE OF SUPERVISING DENTIST Note: Students who have taken DCC’s HLT195 will have done job shadowing as part of the course and do not need to have this form completed or to do additional job shadowing. Persons applying for dental assisting who have done job shadowing should include this form with their completed Application for Basic Dental Assisting.
DANVILLE COMMUNITY COLLEGE DENTAL ASSISTING JOB SHADOWING FORM APPLICANT’S NAME ____________________________________________________ DENTAL OFFICE _______________________________________________________ NUMBER OF HOURS COMPLETED ________________________________________ DATES OF SHADOWNING _______________________________________________ ___________________________________________________________________ SIGNATURE OF SUPERVISING DENTIST Note: Students who have taken DCC’s HLT195 will have done job shadowing as part of the course and do not need to have this form completed or to do additional job shadowing. Persons applying for dental assisting who have done job shadowing should include this form with their completed Application for Basic Dental Assisting.
BDA%20Application%20for%202018%20-%2030Jan2018.docx