DANB Indiana State Booklet Order Form
•
0 likes•288 views
The Dental Assisting National Board (DANB) publishes guides outlining dental assisting requirements and career opportunities in each U.S. state and territory. DANB exams are recognized or required in 38 states and other jurisdictions. Their 2011 publications include a guide with career ladders for dental assistants in each state and a fact booklet with state practice requirements. The documents provide information to help dental assistants learn about requirements and opportunities in different areas.
DANB Indiana State Booklet Order Form
- 1. Questions? 1-800-367-3262 • www.danb.org The Dental Assisting National Board, Inc. (DANB) 2011 State Publications DANB’s state publications are a complete guide to national dental assisting regulatory requirements. DANB exams are recognized or required in 38 states, the District of Columbia, the U.S. Air Force and the U.S. Department of Veterans Affairs. DANB’s 2011 State Career Ladder Templates for Dental Assistants is a reader-friendly guide outlining dental assistant requirements and career opportunities for dental assistants in all 50 states. DANB’s 2011 State Fact Booklet provides current state requirements and excerpts from State Practice Acts re- lated to dental assisting. It also features State Board of Dentistry contact information, accepted/required DANB exams, the number of DANB Certificants in each state, a list of CODA-accredited programs and comparative salary information. Unit Cost (circle one) Quantity TOTAL Certificant Professional DANB’s 2011 State Career Ladder $40 $65 (3480-11) _________ $_________ Templates for Dental Assistants (3480-10) DANB’s 2011 State Fact Booklet $40 $65 (3440-10) (3440-12) _________ $_________ State Guide Pack *special rate*: DANB’s 2011 State Career Ladder Templates for Dental Assistants and $60 $100 _________ $_________ DANB’s 2011 State Fact Booklet Overnight shipping is available for $20. For overnight shipments of more than 10 books or for an international delivery request, please call 1-800-367-3262. Orders for overnight shipping must be received by DANB no later than 2 p.m. CST. Overnight shipping fee $_________ Shipping (U.S. standard rate) and handling are included in the cost. Please allow 3-4 weeks for shipping. ORDER TOTAL $_________ Please print clearly. Name (print or type)_____________________________________________________________ SSN*_________________________________________ Organization Name (only if sending to work address) ________________________________________________________________________________ Address (no P.O. Box numbers)_______________________________________City____________________State__________Zip___________________ Daytime Phone Number (_____)_________________________________ E-mail _________________________________________________________ DANB Certification Number ___ ___ ___ ___ ___ ___ *Social Security Number assists DANB in properly processing the candidate’s order.M DANB no longer accepts purchase orders or personal checks for publication orders. Please indicate payment information below. Cashier’s Check/Money Order payable to the Dental Assisting National Board, Inc. or DANB All DANB publication fees VISA MASTERCARD DISCOVER AMERICAN EXPRESS are nonrefundable. Credit Card Authorization: Allows DANB to charge your credit card account. Please complete all information. Name (print or type)____________________________________________________ SSN*___________________________________________________ Credit Card Number __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date __ __/__ __ Amount $_________________________ Cardholder’s Name______________________________________________Cardholder’s Signature___________________________________________ Cardholder’s Billing Address_____________________________________________________________________________________________________ City/State/Zip_____________________________________________________________Phone Number (_______)________________________________ By signing, the cardholder acknowledges purchase of the aforementioned DANB publications in the amount of the total shown hereon and agrees to perform the obligations set forth in the cardholder’s agreement with the issuer. Furthermore, the cardholder understands that the signature obtained on this form shall be used to indicate receipt of purchase. All DANB publication fees are nonrefundable. FAX to: or MAIL to: 312- 642-8507 Dental Assisting National Board, Inc. DANB Publications 444 N. Michigan Ave., Suite 900 Chicago, IL 60611-3985