
DENTAL HYGIENE APPLICATION NOTICE
Northern Arizona University
Department of Dental Hygiene
(For a Microsoft Word Document, click here. For a PDF document, click here.)
Notice of Received Application
Complete and return with the application packet.
Name __________________________________________
Address _________________________________________________________
**** DO NOT fill out the rest.****
( )Your application to the Dental Hygiene Program has been received and
is complete.
( )Your application is missing:__________________________________________
__________________________________________________________________
__________________________________________________________________
Date__________________ Department of Dental Hygiene_____________________
_ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Directions:
Fold this notice closed on the dotted line. Then type your name and address on the outside of the folded paper. Place a stamp in the upper right hand corner. Enclose this self addressed, stamped notice in the large envelope with your application and transcripts. It will be mailed back to you.
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Dental Hygiene
PO Box 15065
Building 66, Room 202
Flagstaff, Arizona 86011
Phone: (928)523-5122
Fax: (928)523-6195
dental.hygiene@nau.edu
Denise Helm, RDH MA
Department Chair
© 2006 Arizona Board of Regents, Northern Arizona University
South San Francisco Street, Flagstaff, Arizona 86011