WLAC Dental Assistant Information Session
Dental Assistant Information Session
To RSVP, start by selecting the information session you would like to attend:
Please Email Me With More Information About This Program.
Participant Information
Last Name
*
First Name
*
Middle Name
/
/
CA
AK - Alaska
AL - Alabama
AP - Armed Forces Pacific
AR - Arkansas
AS - American Samoa
AZ - Arizona
CO - Colorado
CT - Connecticut
DC - Washington DC
DE - Delaware
FL - Florida
GA - Georgia
GU - Guam
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MP - Northern Mariana Islands
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VI - U.S. Virgin Islands
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Birth Date (Format MM/DD/YYYY)
*
Street Address
*
City
*
State
*
Zip Code
*
-
-
Contact By:
Email
Phone Call
Text
Phone
*
Enter 2nd Phone
Email Address
*
Enter 2nd Email
(Mark All That Apply)
No
Yes
No
Yes
No
Yes
Are You Employed?
*
Do You Have A LACCD Student ID?
*
Are You A Middle School Or High School Student?
* Required