1. A. For a school to participate in the Arizona Dental Sealant Program for a school year and receive dental sealant services, a contact person shall submit to the Department a completed application form provided by the Department that contains:

   1. 1. The contact person’s name, title, telephone number, fax number, and if applicable, e-mail address;
   2. 2. The school’s name, street address, and telephone number;
   3. 3. The school’s mailing address if different than the school’s street address;
   4. 4. The name of the school district and county where the school is located;
   5. 5. The percentage of children attending the school that participated in the National School Lunch Program during the current school year; and
   6. 6. The number of children attending second and sixth grades.
2. B. The Department accepts applications beginning on April 1 for the next school year.

Historical Note

Adopted effective February 23, 1993 (Supp. 93-1). Section expired under A.R.S. § 41-1056(E) at 7 A.A.R. 4275, effective July 30, 2001 (Supp. 01-3). New Section made by final rulemaking at 13 A.A.R. 4190, effective January 8, 2008 (Supp. 07-4).