Dental Hygiene Program

Dental Hygiene Program Dental Hygiene Program Application Packet 1

Program Information The North Central Missouri College (NCMC) and Hillyard Technical Center have established an affiliation to offer a Dental Hygiene education program located at Hillyard Technical Center in St. Joseph, Missouri. Students must be currently enrolled in both Hillyard Technical Center and NCMC and in good academic standing. Graduates of the program will receive an Associate of Applied Science Degree from North Central Missouri College. A minimum of 15 credit hours successfully completed (grade of C or above) at NCMC is required for graduation eligibility. Upon successful completion of the Dental Hygiene curriculum, 30 credit hours will be applied toward the Associate of Applied Science in Dental Hygiene conferred by North Central Missouri College located in Trenton, Missouri. However, the 30 credit hours will not transfer towards a Bachelor s Degree. All courses required for Dental Hygiene admission are offered online through NCMC. The program is a distance education program to better serve the needs of the Northwest and North Central portion of the state. Students who reside in North Central Missouri may receive the didactic portion of the program via ITV at the NCMC campus in Trenton, Missouri, and will need to travel to the Hillyard Technical Center campus in St. Joseph or other clinical location for laboratory and clinic experiences. The Dental Hygiene program is a 22-month full-time program. Classes meet four days a week from 7:30 a.m. through 4:30 p.m. (an additional weekday or Saturday, may be required on occasion). A class of up to 10 will be admitted to begin each Fall. Reliable transportation is a must, as travel to clinical sites up to 90 miles from St. Joseph will be required. NOTE: Application is NOT a guarantee you will be accepted in the program. If accepted, successful finger print/background checks will be contingent upon your enrollment in the program. 2

Minimum Eligibility Requirements: High School Diploma or High School Equivalency. Minimum of a 2.5 prerequisite and general education courses GPA. At least a 20 ACT composite score (completed within the past five years of application deadline) OR 2.8 college GPA on all required prerequisite and general education courses Current enrollment as a student at North Central Missouri College and in good academic standing. Observation of one clinical session at the NCMC/Hillyard Technical Center Dental Hygiene Clinic prior to February 1. To schedule an observation appointment, please call the dental hygiene department at: 816.671.4170. Completion and verification of 12 hours of job shadowing a Registered Dental Hygienist prior to Feb. 1. Application Requirements: Enrollment into the program is limited and admission is competitive. Students must submit a completed application packet including all of the following by February 1. Application does not guarantee acceptance into the program. The completed application packet consists of the following: Non-refundable application fee ($35.00) - please make checks out to Hillyard Technical Center Complete Hillyard Technical Center Adult Application Packet in full Complete Dental Hygiene Program Information form (included in this packet) Complete Confidential Release Waiver (included Hillyard Technical Center Adult Application Packet) Complete the Consent to Share Information Form (included in this packet) Complete Observation/Job Shadow Approval Form (included in this packet) Complete Observation/Job Shadow Verification Forms (included in this packet) Complete Applicant Reference Forms from three business/professional/educational references (i.e. employer, teacher, coach) - personal references will receive no points toward admission). Applicant Reference Form included in the Hillyard Technical Center Adult Program Applicant Packet MUST be used. Official High School Transcript or High School Equivalency submitted to Hillyard Technical Center and North Central Missouri College (http://www.ncmissouri.edu/academics/dental-hygiene/) ACT score submitted to Hillyard Technical Center and NCMC (to schedule ACT test go to: www.act.org) NOTE: it takes several weeks for scores to reach NCMC, so please plan accordingly Official transcript of college courses completed submitted to Hillyard Technical Center and NCMC NOTE: you must be currently enrolled at NCMC and in good academic standing to submit a completed application status (http://www.ncmissouri.edu/academics/dental-hygiene/) Submit to: Hillyard Technical Center - Dental Hygiene Program ATTN: Applications 3434 Faraon Street St. Joseph, MO 64506 3

Course Requirements: All prerequisite and general education course requirements must be taken at an accredited college or university. Dental hygiene curriculum, as most healthcare programs, has a rigorous course of study. The course information referenced below reflects the course schedule for North Central Missouri College. Courses may be taken at any accredited college or university. A minimum of 15 credit hours must be successfully completed from North Central Missouri College to graduate and receive an AAS Degree in Dental Hygiene. PREREQUISITE courses (must be completed prior to enrolling for the first semester of the Program): Course # Course Title Credit Hours Semester Offered BI 238 OR BI 240, BI 242 Anatomy and Physiology 8 F, SP, Su CH 107 Introduction to Chemistry 4 F, SP, Su BI 243~ Microbiology 4 F, SP, Su AH160 Basic Medical Terminology 3 F, SP, Su 4

College level general education courses (must be completed prior to graduation): Course # Course Title Credit Hours Semester Offered HI 103 Or PL 216~ American History to 1877 or National Government 3 F, SP, Su EN 101 English I 3 F, SP, Su SP 175 Speech 3 F, SP, Su PY 121 General Psychology 3 F, SP, Su SO 107 General Sociology 3 F, SP, Su MT 122 College Algebra 3 F, SP, Su BT 240~ Employment Strategies 3 F, SP, Su F=fall Sp=spring Su=summer ~ courses noted with ~ are offered during Christmas and May intersessions Transferability of courses completed at other institutions is determined by NCMC Registrar s office. *NOTE:* A minimum of 15 credit hours must be taken from North Central Missouri College to graduate and receive an AAS Degree in Dental Hygiene. Any uncompleted general education courses (at enrollment date) will be completed on a schedule determined by the Dental Hygiene Program Coordinator. 5

Student Selection Process: Admission into the Dental Hygiene Program is based on the items noted below. Admission is competitive and up to 10 applicants with the highest scores will be offered a position in the class. All applicants will be ranked according to: o Grades for completed (required) prerequisite and general education courses with emphasis on science courses o GPA from all courses required for the Dental Hygiene Program o ACT score within five years of application date (a 2.8 college GPA may be substituted for the ACT) o Professional references (employers, teachers, coaches- personal references will receive no points toward admission) o Job Shadow/Observation Time (minimum of 12 hours) o Personal interview Top scoring applicants will be scheduled for an interview with members of the admissions committee All applicants who have submitted a complete application will be notified, in writing, of their admission status NOTE: Meeting the application criteria does NOT guarantee admission into the program. Requirements for final acceptance: Verification from the Missouri Department of Social Services that applicant is not on the employee disqualification list Completion of a criminal background check (felony conviction may be cause for disqualification) Other screenings as applicable Physical/drug screen examination provided U.S. HealthWorks (positive drug screen may disqualify student from program) Highly recommended immunizations completed - Hepatitis B, HBV titer, MMR, 2 stage TB test, Tetanus, Influenza immunization Completion of all general education and prerequisites with a minimum GPA of 2.5 prior to enrolling in the Dental Hygiene Program Completion of all items indicated in Adult Program Application and Dental Hygiene packets Contact information: Hillyard Technical Center Nancy Horrocks, BS, RDH, MS Dental Hygiene Program Coordinator 3434 Faraon Street 1301 Main St Joseph, MO 64506 Trenton, MO 64683 North Central Missouri College Kristi Cutsinger, MBA Assistant to the Division of Allied Health Sciences 816.671.4170 660.357.6316 nancy.horrocks@sjsd.k12.mo.us kcutsinger@mail.ncmissouri.edu 6

NCMC/ Hillyard Technical Center Dental Hygiene Curriculum Course # Course Title SEMESTER 1 DH 101 Pre-Clinical Dental Hygiene I Fall DH 102 Dental Anatomy Fall DH 103 Head & Neck Anatomy Fall DH 104 Dental Radiology Fall DH 105 Pathophysiology of Med Compromised Patient Fall SEMESTER 2 DH 121 Clinical DH II Spring DH 122 Periodontology Spring DH 123 Histology & Embryology Spring DH 124 Oral Pathology Spring DH 125 Oral Health Education/Counseling Spring SEMESTER 3 DH 204 Dental Biomaterials Summer DH 201 Clinical DH III Fall DH 202 Pharmacology Fall DH 203 Evidence Based Decision Making Fall DH 222 A Community Oral Health Lecture Fall DH 206 Human Nutrition Fall SEMESTER 4 DH 221 Clinical DH IV Spring DH 222 B Community Oral Health Practicum Spring DH 223 Ethics and Law Spring DH 224 Board Review Spring DH 225 Independent Study Spring 7

Dental Hygiene Program Hillyard Technical Center North Central Missouri College 3434 Faraon Street St Joseph, MO 64506 816.671.4170 1301 Main Street Trenton, MO 64683 660.357.6316 Check Off List for Applicants For your convenience we have provided this check off list to assist you in completion of your application to the NCMC/ Hillyard Technical Center Dental Hygiene Program. To be considered for the limited number of openings in the program for which you have applied your file must be complete. 1) Non-refundable application processing $35.00 fee enclosed 2) Official High School Transcript or High School Equivalency 3) Official Post-Secondary Transcript(s) submitted OR 4) Proof of enrollment as student at North Central Missouri College and in good academic standing 5) References (3) valid submitted (business/professional - not personal) completed on the Reference Form included in the Adult Application Packet 6) ACT (no older than five years from application date) completed and submitted to NCMC and Hillyard Technical Center -OR- evidence of 2.8 college GPA (required general education and prerequisite courses only) 7) Observation/job shadow of a clinical dental hygienist (12 hours minimum) APPROVAL MUST PRECEED OBSERVATION - see form included in Dental Hygiene Program packet 8) Completed observation of one NCMC/Hillyard Technical Center Dental Hygiene clinic session 9) Confidential release waiver signed and submit (included in Hillyard Adult Application) 11) Signed Consent to Share Information 10) Complete Hillyard Technical Center Adult Program Application in full 11) Complete Federal background check submitted to Hillyard Technical Center 12) File is complete Should you have questions or concerns about your application, please call 816.671.4170. 8

NORTH CENTRAL MISSOURI COLLEGE/HILLYARD TECHNICAL CENTER DENTAL HYGIENE PROGRAM ADDITIONAL INFORMATION FORM Please complete the following form. We realize that you may not have an answer for all of the blanks. If you do not have a response, please write NA. Please use the back if you run out of space. Name Last First Middle Other Names (including Maiden) Used: Work Experience (start with your most recent employment): EMPLOYER City/State Position Dates (From-To) Reason for leaving ~~~~~~ EMPLOYER City/State Position Dates (From-To) Reason for leaving ~~~~~ EMPLOYER City/State Position Dates (From-To) Reason for leaving May we notify any or all of these employers for recommendations? Yes No If no, which ones? 9

Additional Information Page 2 EDUCATIONAL BACKGROUND (use an additional page if necessary): High School Name Location High School Diploma Yes No High School Equivalency (# ) Dates Attended to College Name Location Area of study Dates Attended: to Degree: Yes No Type Area of Study I certify that the answers given herein are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, or medical history and other related matters as may be necessary in arriving at a decision for admission to this Hillyard Technical Center Dental Program. I hereby release employers, school, or persons from all liability in responding to inquiries in connection with my application with the exception of: Signed Date Hillyard Technical Center is required by Title VI, Title IX, and section 504 not to discriminate on the basis of sex, race, color, creed, age, handicap or national origin in its educational activities. Any persons having inquiries relating to the above regulations is directed to contact the Director of Social Services, 10 th and Felix Street, St. Joseph, MO 816.671.4000 /the administrators have been designated to coordinate the efforts of the school district of St. Joseph to comply with the title IX, title VI and section 504 guidelines. 10

North Central Missouri / Hillyard Technical Center Dental Hygiene Approval Form for Prospective Dental Hygiene Student Job Shadowing 816.671.4170 Phone Subject: Observation/job shadow of a Registered Dental Hygienist Topic: The NCMC/Hillyard Technical Center Dental Hygiene Program requires that the applicants to our program observe a Registered Dental Hygienist in the private practice setting for a minimum of twelve (12) hours prior to application. Sign off: We require Dental Hygiene applicants to obtain written permission prior to this observation time. Please sign below and fax this form to the number listed below and direct any questions or concerns to Nancy Horrocks, DH Program Coordinator at 816.671.4479. Thank you. *I/we agree to allow a dental hygiene applicant to visit our practice/facility to observe a Registered Dental Hygienist.. Printed Name of office/clinic employee or dentist Signature of office/clinic employee or dentist Date Dental office/clinic name printed Phone Prospective Student s Name Please sign and fax to: 816.671.4479 11

North Central Missouri / Hillyard Technical Center Dental Hygiene Certification of Observation/Job Shadow Time Observation/Shadow Time with Registered Dental Hygienist (RDH) This is to verify that (Prospective Dental Hygiene Student) has observed a Registered Dental Hygienist for a minimum of twelve (12) hours in partial fulfillment of requirements for the Dental Hygiene Program application. Please make comments on the individual that has fulfilled his/her observation time with your office. Comments: Number of hours of observation: Signature of RDH: Office of: Phone: Date: Dear Registered Dental Hygienist: Please fax or mail this completed form to: Hillyard Technical Center Dental Hygiene Program ATTN: Admissions 3434 Faraon Street St. Joseph, MO 64506 816.671.4170 phone; 816.671.4479 fax N ***Requirement may be met by observing multiple dental hygienists or in multiple dental offices 12

. CONSENT TO SHARE INFORMATION I,, acknowledge that as an applicant to Hillyard Technical Center s Dental Hygiene program, I am also required to apply and be accepted to North Central Missouri College (NCMC). If admitted to both institutions, I realize I will be taking courses through both entities concurrently. For the continuity of my education, I realize that there will be active sharing of my academic information between Hillyard Technical Center and North Central Missouri College beginning upon the submission of application to either Hillyard Technical Center and/or NCMC. I understand that for financial aid purposes, this form does not replace any consortium agreements that will need to be completed on my behalf. Due to the relationship between Hillyard Technical Center and NCMC and the affiliation agreement in place, I consent to the active and continual sharing of my educational records between both entities. I understand that education records include, but are not limited to, information about my academic standing, disciplinary issues, and financial obligation to either entity. I acknowledge that this Consent to Share Information will be in effect from the time application is received by Hillyard Technical Center or NCMC and will continue until I stop enrolling or graduate from either institution. I acknowledge that I may revoke this Consent to Share Information at any time and must inform Hillyard Technical Center and NCMC in writing to do so. I further acknowledge that revocation of this consent will hinder Hillyard Technical Center and NCMC in providing accurate academic advising. Student Name: First Middle Last Student Signature: DECLINE TO CONSENT TO SHARE INFORMATION The above Consent to Share Information form will not apply to me,, since it will not be necessary for me to take courses at both institutions for the above listed program. Student Name: First Middle Last Student Signature: 13