8-Week Website Enrollment & Assessment

Dental Assisting Academy of the Palm Beaches Assessment

Please answer the following questions to complete the DAAPB Assessment
Why do you want to be a Dental Assistant? *
What do you already know about the job as a dental assistant? *
What do you hope to gain & accomplish by becoming a dental assistant? *
What qualities & traits do you have that you think will make you an asset in the dental field? *
Will you be able to manage your time with your current schedule and the course? *
What do you think is a good starting hourly pay for a dental assistant? *
What does the ideal dental assistant look like to you? *
What is your Instagram Name?! We would love to follow you!
What is your current employment? *
What shifts at work do you take? *

Opening/Morning Shift Closing/Night Shift I make my own schedule
How did you hear about Dental Assisting Academy? If you were referred to us, please let us know by who! *
Do you have a minimum of a High School Diploma or GED? *International Degrees are accepted *

Yes No
Please Note: Students who DO NOT have a High School Diploma or GED are subject to take an Entry Exam (Aptitude Test) to determine eligibility into the Program.
When did you want to come in for a Tour & Enrollment at the Academy? We are open on Tuesday, Wednesday, Thursday & Saturday! *
When did you want to come in for a Tour of the Academy? We are open on Tuesday, Wednesday, Thursday & Saturday! *

Month Day Year
Date
Please Upload a recent photo of yourself. Smile! *

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Choose between these two options

1. An Application Fee is necessary for the application.

2. Making a deposit will enroll you in the class of your choice. The Application Fee is included in the Deposit. This will ensure your spot is safe!
1. Application Fee $25.00
2. Deposit Fee $600.00
3. Full Class Tuition $3800
*The Application Fee is non-refundable. If the student is not accepted into the program and a Deposit Fee is made a refund of $575 (Application Fee deducted) will be given on original payment method.

*All enrollments regardless of payment choices are still under the admissions committee review until accepted into the program.

*Be selecting Option 2 ($600.00 Deposit Fee) you do not have to pay the Application Fee, all monies paid will be credited towards tuition

Options: *

Application Fee $ 25.00

Class Deposit $ 600.00

Class Tuition $ 3,800.00

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Total $ 0.00

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Student Enrollment Application

Dental Assisting Academy of the Palm Beaches Assessment