Register for ADAPT's 10 week & 4 week Dental Assisting Classes

Ready to get started?

Step 1: Fill Out And Submit The Application Below with your $125 Deposit

Step 2: Review your Financial Options with our Director

Step 3: Set up your Payment plan and apply for a grant

Step 4: Attend Orientation and Complete Enrollment Paperwork

Please complete the form below to reserve your seat in class!

First Name

Last Name

Address

Apt #

City

State

Zip

Phone

Session

Program

Payment Options

Comments/Questions

This $125 payment reserves your seat in the selected class.
This is non-refundable after 5 days

Credit or debit card

Referral Code