2022 Youth Summer Dental Program

Thank you for your interest in the 2022 Youth Summer Dental Program.
Eligibility requirements apply for New Mexico Workforce Connection's Tuition Assistance Program.

Before completing the contact form, you must be:

18 years of age on or before May 20, 2022
a high school graduate on or before May 20, 2022
must reside in one of the following New Mexico counties: Catron, Doña Ana, Grant, Hidalgo, Luna, Sierra, Socorro

1. Contact Information: *This question is required.

First and Last Name: *This question is required.

Email address: *This question is required. This question requires a valid email address.

Phone Number: *This question is required.