Pure Dental Academy Mesquite

Application

Mesquite Location
Pure Dental Assistant Academy
301 W. Grubb Dr.
Mesquite, Texas 75149
469-472-1142
"Dental Assisting" Program Information and Qualifications

Student must have a High School Diploma, GED, or college transcript.

Student must pass background check to be accepted to the Pure Dental Academy Dental Assisting Program.

Tuition: $2950.00- Includes MINT dentistry Scholarship of $550. Includes: Books, uniforms, supplies, CPR certification, Nitrous Oxide Monitoring testing, and RDA test.

Length of program: 7 weeks, 40-hour externship with Mint Dentistry after completion of course for eligible students. The student will take the RDA test through the Texas State Board of Dental Examiners. Tuition must be paid in full before Student will be allowed to take the State Board Exam.

Upon completion of your application, a $100 non-refundable deposit is required to finalize your application. This deposit will be deducted from the total tuition cost.

Form was revised on September 24, 2021

Tuition
Payment Plan (payment not required to apply | Upon completion of your enrollment, a $100 non-refundable deposit is required to finalize your application and process your background. This deposit will be deducted from the total tuition cost.): *

Paid in full. Remaining tuition will be divided into 6 consecutive payments. Remaining tuition will be divided into 3 biweekly payments.
No interest will be charged for any of the above payment plans.

ALL Payment plans will be created on the first day of class.
Choose Method of Payment (payment not required to apply | Upon completion of your enrollment, a $100 non-refundable deposit is required to secure your spot in the class. This deposit will be deducted from the total tuition cost.): *

Money Order Cashier Check Cash Credit Card Other
"Any holder of this consumer credit contract is subject to all claims and defenses which the debtor could assert against the seller of goods or services obtained pursuant hereto or with the proceeds hereof. Recovery here under by the debtor shall not exceed the amounts paid by the debtor here under."

How did you hear about us?
Referral: Choose as many that apply:

Facebook Instagram Google Friend/Co-worker TV Radio School
Referral Name

First Name Last Name

Signatures
Cancellation Policy *
Refund Policy *
Acknowledgments *
Approved and regulated by the Texas Workforce Commission, Career Schools and Colleges, Austin, Texas.
Student Name *

First Name Last Name
Student Signature *
Date *

Month Day Year
Date
Parent or Guardian Signature
Date

Month Day Year
Date
Once you select submit on this application, do not exit out of your screen. You will be redirected to complete your background authorization form. In order for us to process your application and background, both of these forms are required.

Application