ASDH Application

General Application for Admission to the ASDH Program

Admission to the dental hygiene program is a four step process: admission to Georgia Highlands College, submission and acceptance of all required documentation, an interview (top 20 candidates), and acceptance into the dental hygiene program. Applications for the ASDH Program can be submitted from January 1st - March 15th.

The department will only review applications for those applicants who have met the following criteria:

Earned a minimum cumulative GPA of 2.5 out of 4.0 on the GHC Dental Hygiene Core Curriculum (all courses must be a "C" or better)
Earned a minimum TEAS composite score of 65 with no more than two attempts in an application cycle
Completed CHEM 1211K, BIOL 2121K and BIOL 2122K with grade of "C" or better, by end of the spring semester that you are applying
Biology courses must be less than six years old. If Biology courses are older than 6 years old at time of application, then these courses must be retaken prior to applying to the program. Includes BIOL 2121K, 2122K, 2161K, and Nutrition.
Applicants must also attend at least one information session in the 12 months preceding the March 15th deadline. Proof of attendance must be submitted with this application.

A minimum cumulative GPA of 2.5 out of 4.0 is required for consideration.

Compliance with the above minimum requirements does not guarantee admission to the GHC Dental Hygiene Program. The records of all applicants who meet the minimum requirements will be reviewed. Students who are selected for the interview will be notified by telephone or email. Students who are admitted to the program will be notified by email or US Mail.

Please reference the GHC ASDH Application Checklist which can be found on the website. All forms that must be included in your application can be located on the GHC Dental Hygiene ASDH website at: https://sites.highlands.edu/dental/programs/associates-program/

January 20, 2025, 11:01 pm

* These fields are required.

* Have you applied before in a previous semester for this program?

Yes

Name and Date of Birth:

* First Name

* Last Name

Middle Initial

Maiden Name

* Date of Birth

Contact Information

GHC ID (Current Students Only)

*Email (GHC if available)

* Phone

* Phone Other

Address

* Street Address

* City

* State

* Zip

* County

Emergency Contact Information

* Emergency Contact Name

* Relationship to Emergency Contact

* Emergency Contact Phone

* Have you been arrested of a crime other than a a minor traffic violation?

Yes

* Have you ever been licensed in the health care field?

Yes

Education Background - All official transcripts must be sent to the GA Highlands Office of Admissions

List schools attended. Identify college level degrees earned. Click the Add Row button to add additional rows.

School Attended

Degree Earned

Years Attended

ATI TEAS Composite Score (Minimum of 65 is Required for All Applicants)

* ATI Score

* Date Taken

Health-Related Work Experience

List organization. Identify position held. Identify years worked. Click the Add Row button to additional rows.

Organization

Position Held

Years Worked

File Upload Information: the sum of all attached files cannot exceed 100MB. Files extensions may be: .jpeg, .jpg, .png, .pdf, .doc, .docx, .xls, and .xlsx

Upload Documentation of 30 Hours of observation w/ a dental hygienist:
* Click "Browse" and select file for upload:

Upload personal statement:
* Click "Browse" and select file for upload:

Upload proof of admission to Georgia Highlands College (attach copy of your fee payment for the current term, or a letter of acceptance to Georgia Highlands College) One of these documents MUST be included in your application. :
* Click "Browse" and select file for upload:

Sign and upload the Bloodborne Pathogen and Infectious Disease Acknowledgement Form. The form can be located at: https://sites.highlands.edu/dental/wp-content/uploads/sites/28/2018/04/Bloodborne-Pathogen-Acknowledgement-Form.pdf:
* Click "Browse" and select file for upload:

Upload Proof of attendance at a Dental Hygiene Information Session:
* Click "Browse" and select file for upload:

I understand (check to agree with each of the following statements):

*	Criminal background checks and drug screenings are required for clinical practice by institutions used by the dental hygiene program for the clinical experiences associated with dental hygiene courses. A student will be required to participate in these checks upon admission and at least annually while in the program. All criminal background checks and drug screens will be at the expense of the student. Clinical experience is a component of all required dental hygiene courses. A course cannot be satisfactorily completed without completing the clinical component of the course. Should a student be denied placement by a clinical facility related to results on a criminal background check or drug screening, the student will be dismissed from the program with no opportunity for readmission.
*	A student who has been arrested or convicted of a crime other than a minor traffic violation may be admitted into the dental hygience program at Georgia Highlands College, but permission to take the Licensure Examination rests with the Georgia Board of Dentistry. If you have been arrested or convicted of a crime other than a minor traffic violation, please make an appointment with the Director of the ASDH Prgram at rgupta@highlands.edu, please copy krice@highlands.edu on these emails to receive further instructions.
*	I have read and understand the essential functions necessary for admission and progression in the Dental Hygiene Program (See Catalog for details). Program accommodation(s) can be made with approval from Student Support Services.

Please Read Carefully and Sign:

I hereby certify that the facts set forth in the above application are true and complete to the best of my knowledge. I understand that if accepted, falsified statements or withheld pertinent data on this application shall be considered sufficient cause for dismissal. Georgia Highlands College is hereby authorized to make any investigation on my personal history.

* Sign on the line below with mouse (PC), stylus (touch screen), or your finger (touch screen). Click the Save Signature button once you are satisfied with your signature.