Administrator Verification

Self-Study Guide for the Evaluation of a

Dental Hygiene Education Program

The Commission requires appropriate administrators of the institution* to verify that the contents of the application are factually accurate.

SPONSORING INSTITUTION

Name: Lake Superior CollegeStreet Address: 2101 Trinity RoadCity, State, Zip: Duluth, MN  55811
Chief Executive Officer (Univ. Pres., Chancellor, Hospital President)Name: Dr. Kathleen NelsonTitle: President

Phone: 218-733-7637

Signature:

Date:

Chief Administrative Officer (Dean/Chief of Dental Service)Name: Ms. Pam ElstadTitle: Dean of Allied Health and Nursing

Phone: 218-733-5911

Fax: 218-723-4921

E-Mail:p.elstad@lsc.edu

Signature:

Date:

Program director/administrator or Co-Program director/administratorName: Ms. Kathy LeonardTitle: Dental Hygiene Program Director

Phone: 218-733-5938

Fax: 218-723-4921

E-Mail: k.leonard@lsc.edu

Signature:

Date:

*If the program is co-sponsored by more than one institution, the appropriate administrators of both institutions must verify the contents of the application. This page may be expanded to include all verifications.