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Korean American Dental Association
Summer Internship Program
Application Form
Contact Information:
Name
Gender
Male
Female
Date of Birth
Email
Phone
Address
Vaccinated for Hepatitis B? (Strongly recommended)
Yes
No
Academic Information:
High School
GPA
Honors & Awards
Undergraduate School
GPA
Estimated Graduation Year
Major
Honors & Awards
DAT Score (If applicable)
Keep In Mind:
Hepatitis B Vaccine strongly recommended for applicants
Transportation and marking must be arranged individually
Certification
I certify the information I provided on and in connection with this form is true and correct to the best of my knowledge. I also understand that false or deliberately omitted answers may be grounds for dismissal.
Submit Application
