S.P.I.C.E. Course Application Please enable JavaScript in your browser to complete this form.NameFirstLastAddressAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate of BirthEmailHome / CellParent, Guardian, or Spouse NameParent, Guardian, or Spouse Home / Cell High School/College NameYear of Grad. Please Select High School GraduateGEDCollegeHow I heard about this programIn case of emergency contact:NamePhoneRelationshipState, ZipCourse Description:S P I C E is the Statewide Program for Infection Control and Epidemiology Section 10A NC Administrative code 41A.0206 states: Dental offices shall designate one staff member to direct infection control activities. This person is required to complete a course approved by the state in infection control. This course is a 5 hour course and fulfills the requirement for sterilization and infection control for DAII status.Cancellation, refund, and requirements policy:A full refund of all monies will be made to any applicant who cancels the enrollment agreement within 3 business days of the first class. Submit