GHC BSDH Program Application

General Application for Admission - RDH to BSDH Completion Program

Admission to the dental program is three step process: admission to the college, submission and acceptance of all required documentation, and acceptance to the dental program.

A minimum cumulative GPA of 2.5 out of 4.0 is required for consideration. Applicant must hold an associate or diploma degree in dental hygiene from a CODA accredited dental hygiene program.

Compliance with the above minimum requirements does not guarantee admission to the RDH to BSDH Completion Program. The records of all applicants who meet minimum requirements will be reviewed after the application deadline and students who are admitted will be notified by mail.

March 20, 2023, 12:31 pm

* These fields are required.

Name and Date of Birth:

* First Name

Last Name*

Middle Initial

Maiden Name

* Date of Birth

Demographic Data for Accreditation Purposes:

* Marital Status?

Married

Widowed

Divorced

Single

Race/Ethnicity *

* Gender

Male

Female

* English as a Second Language?

Yes

Contact Information

GHC ID (Current or Previous Students Only)

Email *

Phone *

Street Address*

City *

State *

Zip *

County *

Emergency Contact Information

* Emergency Contact First and Last Name

*Relationship to Emergency Contact

Emergency Contact Phone *

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

List schools (post high school) or colleges attended. Identify college level degrees earned. Click the Add Row button to additional rows.

School Attended

Degree Earned

Years Attended

License Uploads: max size for each file is 50MB. Files extensions may be: jpeg, jpg, png, gif, pdf, or tif.

*Are you currently licensed as a Registered Professional Dental Hygienist?

Yes

Upload copy of Dental License (if applicable):

Click "Browse" and select file for upload:

Upload driver’s license or government issued ID:

Click "Browse" and select file for upload:

* Do you have a current health care license other than dental?

Yes

Upload CPR Certification:

Click "Browse" and select file for upload:

I understand (check to agree with the following statement):

In order to be accepted into the program and register for required BSDH courses, evidence of the following are required: professional licensure, immunizations, current CPR, and must hold an associate or diploma degree in dental hygiene from a CODA accredited dental hygiene program..
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. *

General Application for Admission - RDH to BSDH Completion Program

School Attended

Degree Earned

Years Attended

List other Dental Licenses (click add row for more than one)