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Apply to Dental Depot Academy's
Dental Assistant Program

Now Accepting Applications for Fall 2021!

Dental Depot Academy Application

Application Date*
Date Format: MM slash DD slash YYYY
Program Term*
Student Information
Student's Name*
First Middle Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Current Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone*
Primary Email*
Secondary Email
Preferred Method of Contact*
Referral Source*
Have you previously applied to the Dental Depot Academy of Dental Assisting?*
- Yes
- No
Education Information
This position requires a high school diploma or GED. Do you meet this requirement?*
Attach copy of HS Diploma/Transcript or GED*
Please answer the questions below
Why do you want to be a Dental Assistant and what interests you about the dental industry?*
In addition to the classroom and labs, part of the program requires that students travel to and from other Dental Depot clinics as they complete their hands-on clinical rotations each week. Do you have reliable transportation to get to and from classes and clinical sites?*
Attendance is an important factor for being in the program. If selected, are you able to commit to the full 12-week program, Monday through Friday 7:45am – 12:00pm?*
If selected for the program, there will be a New Student Orientation approximately one month before the start date. A minimum down payment of $1,500 will be due at that time in order to secure your spot and obtain the necessary documents needed for your clinical rotations. Will you have the funds for this?*
One of the requirements for receiving your dental assisting permit is that you are able to pass a background check. Do you have any concerns with this?*
If yes, please explain:
How did you hear about us?*
I have read and understand the admission criteria for Dental Depot Academy of Dental Assisting. I understand it is my responsibility to meet all application criteria. I understand falsification of any information may lead to disqualification or dismissal from the Academy. I understand that failure to sign and date this application renders my application ineligible.
E-Signature*
Date
Date Format: MM slash DD slash YYYY
Be sure to have your application in prior to the deadline to be considered for an interview. The application deadlines are located on the Dental Depot Academy of Dental Assisting website. If selected for an interview, you will need to bring identification on the day of the interview.

Have Questions About Dental Depot Academy?

We’re here to help. Send us an email at academy@dentaldepot.net or call at 405-296-6123

Apply Now!

Apply to Dental Depot Academy's
Dental Assistant Program

Dental Depot Academy Application

Have Questions About Dental Depot Academy?

Quick Links

Contact Us

Apply Now!

Apply to Dental Depot Academy's Dental Assistant Program

Dental Depot Academy Application

Have Questions About Dental Depot Academy?

Quick Links

Contact Us

Apply to Dental Depot Academy's
Dental Assistant Program