Request to become a CDCA Consultant Examiner

What year did you graduate from dental or dental hygiene school?
Do you have a current, full, and unrestricted license to practice in the US or Jamaica?
(Faculty license is not acceptable.)
Who recommended that you apply?
Referrer is a:

If approved, I am willing to accept and participate in at least 2 examiner assignments each year involving dental, dental hygiene, manikin grading, or EFDA examinations in locations throughout the US, Canada, and Jamaica.
Your application has been sent!