Application for Registered Dental Assistant Examination
This file contains the application for the Registered Dental Assistant Examination and Licensure in California. It includes the necessary fees, documentation requirements, and detailed instructions for applicants. Perfect for aspiring dental professionals in California.
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How do I fill this out?
To fill out this application, start by providing your personal information accurately. Ensure to check the required documentation specific to your situation, especially if you have military or asylum status. Lastly, review your responses for accuracy before submission.
How to fill out the Application for Registered Dental Assistant Examination?
1
Gather all personal identification information, such as SSN and birth date.
2
Provide your legal name and any other names used in the past.
3
Fill in the mailing address and contact information accurately.
4
Answer questions regarding previous licensure or disciplinary actions.
5
Submit the application along with the required fees and documentation.
Who needs the Application for Registered Dental Assistant Examination?
1
Individuals pursuing a dental assisting career in California.
2
Previous dental professionals looking to reinstate their licensure.
3
Internationally trained dental assistants seeking licensure in California.
4
Military spouses or partners wishing to expedite the application process.
5
Applicants who have declared asylum status in the United States.
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3
Review your edits for accuracy.
4
Save the edited PDF to your device.
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What are the instructions for submitting this form?
Submit your completed application form along with the required fee to the Dental Board of California at 2005 Evergreen St., Suite 1550, Sacramento, CA 95815. You may also choose to fax your application to (916) 263-2140 or submit online through the California Dental Board website. To ensure your application is processed without issues, please double-check that all sections are completed and the necessary documentation is included.
What are the important dates for this form in 2024 and 2025?
There are no specific dates listed for submission, but timely completion is encouraged to meet licensure requirements. For updates on examination schedules and application deadlines, applicants should refer to the Dental Board of California's official calendar for 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to provide a structured application for individuals aspiring to obtain licensure as Registered Dental Assistants in California. It guides applicants through the necessary steps and documentation needed to demonstrate their qualifications. Ensuring that all required fields are completed accurately is crucial for a smooth application process.
Tell me about this form and its components and fields line-by-line.
- 1. SSN/ITIN: Social Security Number or Individual Taxpayer Identification Number.
- 2. Birth Date: Applicant's date of birth in MM/DD/YYYY format.
- 3. Legal Name: Full legal name as it appears on identification documents.
- 4. Other Names Used: Any prior names the applicant might have used.
- 5. Mailing Address: Address to which communications will be sent.
- 6. E-Mail Address: Email address for correspondence.
- 7. Home Telephone: Primary contact number including area code.
- 8. Work Telephone: Alternative contact number including area code.
- 9. Previous Licensure: Information regarding any previous licenses held by the applicant.
- 10. Initial Application Asylum Question: Questions related to asylum status.
What happens if I fail to submit this form?
Failure to submit this application means you won't be eligible to take the Registered Dental Assistant Examination. It may result in delays in your licensure process as you must reapply. Ensure that all required fields and documentation are included to avoid setbacks.
- Missing Documentation: Not providing required documents can lead to application rejection.
- Incomplete Information: Leaving fields blank or providing inaccurate data can delay application processing.
- Failure to Pay Fees: Non-payment of the application fee will result in ineligibility.
How do I know when to use this form?
- 1. Applying for New Licensure: Use this form to obtain your first licensure as an RDA.
- 2. Reinstating Licensure: For individuals who have previously held a dental license and are reapplying.
- 3. International Applicants: Individuals trained outside the United States seeking to practice in California.
Frequently Asked Questions
What is the purpose of this application?
This application is for individuals seeking to become Registered Dental Assistants in California.
How do I submit this application?
You can submit your application by mail or online depending on your preference.
Is there a fee associated with this application?
Yes, there is a non-refundable application fee of $120.
What documents do I need to submit?
You'll need to provide identification, proof of residency, and any relevant licenses.
Can I edit this PDF before submitting?
Yes, you can easily edit this PDF using PrintFriendly's editing features.
How do I know if I qualify for expedited application?
If you are a military spouse or an asylee, you may qualify for expedited processing.
What should I do if I have a disciplinary action against my license?
You must disclose this information and provide relevant details in your application.
Can I fill this application out online?
Yes, an online form is available for convenience.
How do I check the status of my application?
You can visit the Dental Board of California's website to check your application status.
What if I made a mistake on my application?
You can edit your document in PrintFriendly before finalizing your submission.
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