Dental Office
By completing this form your office will be posted to all DAAPB student! This includes currently enrolled students and DAAPB Alumni. We love building relationships with our Offices, if you need any assistance please contact Miss Kennedy at 561.900.7141 by call or text, you may also email at office@daapb.com.
Office Name
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Doctor's Name
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What type of student are you looking for?
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Extern Student
Graduate
Both Extern Student and Graduate
By selecting "Extern Student" means that you are looking for a student is still enrolled in our 8-week program. Typically for Clinical Training Hours.
Externship allows for our students to receive that "on the job" training before they graduate. All students are required to obtain 65 office hours prior to certification. Students can be utilized in anyway that works best for your office!
By selecting "Graduate" that means that you are looking for a student that has either recently graduated or a DAAPB Alumni. Typically for Job Hiring.
Would your office want to be considered for always extern?
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Yes
No
By selecting "Yes" to this option, you are NOT binding to ALWAYS take an externs student.
Students understand that is still on a case by case bases.
By selecting"Yes" your office is stating they are more willing to accept and help aid in the student education process.
What type of speciality is found at your office? Select All that Apply
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Endodontic
Orthodontics
Oral and Maxillofacial Surgery
Pediatric Dentistry
Periodontics
Prosthodontics
General Dentistry
Other
Part-time or Full-Time
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Part-Time
Full-Time
How many approximate hours in a work week:
Ex: 20-25 hrs or 40+ hrs with overtime
What days of the week is this opportunity available? Select All That Apply
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Bilingual?
Spanish
Creole
American Sign-Language
Russian
Other
Is Bilingual a Requirement or a Preference?
Requirement
Preference
Please provide a brief description of your dental office, and how you would like students to contact your office:
*
The more information you provide to us, the better dental assistant we can get for you!
Certain Requirements or Specifications?
Please let us know any specifics that you are thinking of when you picture a dental assistant in your office.
Estimated Hourly Offer:
This is not a required field and does not require you to offer or pay the amount list. This is to give the individual an idea of the hourly pay range that COULD be offered. If this is an Externship ONLY opportunity, it is NOT expected to be a paid opportunity.
Contact E-mail
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Contact Phone Number
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-
Area Code
Phone Number
Office Website
Preferred Contact Method (Select all options)
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Email
Phone Call
Phone - Text Message
Other
Preferred Contact Method
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Email
Phone Call
Phone- Text Message
Other
Contact Name
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First Name
Last Name
Office Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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eSwatini
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Other
Country
Where did you hear about us?
*
A Friend or colleauge
Google
Facebook
Currently have an Extern!
Other
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