Get Functional Team Request 2020!
Fill out this form to apply for a Dental Assisting team in your state.
Space is limited therefore we will contact you and confirm that a team has been assigned to you. Only one entry per school unless your program can support 6 or more students (3 students per team) Additional teams may be available closer to the Event.
Scheduled Events for 2020:
2/15 Indian River State College, Florida
2/29 Howard Community College, Maryland/DC
3/14 Wayne County Community College District, Michigan
4/4 Delaware Tech College, DE/NJ/Philly, Delaware

***This is a request for a team. We will contact you to officially register you and assign you a team color.***
Email address *
State your are requesting a team for
Clear selection
Name of Program/School and contact information (name, email, phone number, address)
Teams are comprised of 3-6 students. If there is availability, would you be interested in a second team?
Clear selection
Comments or request of information
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy