Request to become a 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(n):

Needs for examiners will vary according to location. Acceptance as a consultant examiner does not guarantee assignment at an exam site. If approved, I am willing to submit preferences for examinations where I am able to serve and accept and participate in assignments as requested for either dental, dental hygiene, local anesthesia, EFDA examinations, or manikin grading. 
Your application has been sent!