Dental Assistant Pro Online Enrollment Agreement

DENTAL ASSISTANT PRO
Enrollment Agreement

767 Columbus Avenue, Lebanon, OH 45036
513-515-6611
Reg. #04-11-1742T

Date:
09/25/2023

Location

Session*

Start Date

End Date

Hands-On Date

Start Date

End Date

Hands-On Date

Start Date

End Date

Hands-On Date

Start Date

End Date

Hands-On Date

Start Date

End Date

Hands-On Date

Start Date

End Date

Hands-On Date

Student Name*

First Last

Address*

Street Address City State Zipcode

Phone*

Email*

Referral Source*

Referral Name*

Referral Phone

(If former student referral, please enter their phone number)

Expected Program Length:
9 weeks

Program Schedule:
3 weeks of online training (40 hours) 7 Saturdays, each 6 1/2 hour long sessions 8:00 a.m. to 3:00 p.m. (42 contact hours) Total hours 82

Tuition and Fees:
Registration Fee (non-refundable after 5 business days from signing): $125.00
Book Fee: ……………$75.00
Tuition: …………………$3,575.00
Total Cost: ………..$3,775.00

Payment:
Payable 2 weeks before the start of the enrolled session. See payment plan options on page 3. Tuition and fee charges are subject to change at the discretion of the school. Any tuition or fee increases will become effective for the school term following student notification of the increase.

Placement and Graduation Rates:
Dental Assistant Pro at our Lebanon location has a graduation rate of 97% for 7/1/21-6/30/22, 91% for 7/1/20-6/30/21, and 100% for 7/1/19-6/30/20. The Placement rate is for 7/1/21-6/30/22 is 100%, for 7/1/20-6/30/21 is 95%, and for 7/1/19-6/30/20 is 89%.

I am hereby enrolling in the Dental Assisting Program for the term stated above and my enrollment is subject To the terms and conditions in this enrollment agreement.

Applicant Signature*

Date:
09/25/2023

DENTAL ASSISTANT PRO
Refund Policy

767 Columbus Avenue, Lebanon, OH 45036
513-515-6611
Reg. #04-11-1742T

If the student is not accepted into the program, all monies paid by the student shall be refunded. Refunds for books, supplies and consumable fees shall be made in accordance with Ohio Administrative Code section 3332-1-10.1. There is one (1) term for this program that is 9 weeks in length. An enrollment agreement or school application may be cancelled within five calendar days after the date of signing provided the school is notified of the cancellation in writing. Refunds for tuition and refundable fees shall be made in accordance with the following provisions as established by Ohio Administrative Code section 3332-1-10:

A student who withdraws before the first class and after the 5-day cancellation period shall be obligated for the registration fee.
A student who starts class and withdraws before the academic term is 15% completed will be obligated for 25% of the tuition and the refundable fees plus the registration fee.
A student who starts class and withdraws after the academic term is 15% but before the academic term is 25% completed will be obligated for 50% of the tuition and refundable fees plus the registration fee.
A student who starts class and withdraws after the academic term is 25% complete but before the academic term is 40% completed will be obligated for 75% of the tuition and refundable fees plus the registration fee.
A student who starts class and withdraws after the academic term is 40% completed will not be entitled to a refund of the tuition and fees.

DENTAL ASSISTANT PRO
Enrollment Grievance Agreement

767 Columbus Avenue, Lebanon, OH 45036 Reg. #04-11-1742T

Cancellation and Settlement Policy
An enrollment agreement may be cancelled within five calendar days after the date of signing provided the school is notified of the cancellation in writing. If such cancellation is made, the school will promptly refund in full all tuition paid and refundable fees pursuant to the enrollment agreement and the refund shall be made no later than thirty days after cancellation. This provision shall not apply where a student has already started classes.

Complaint or Grievance Procedure
All student complaints should first be directed to school personnel involved. If no resolution is forthcoming, a written complaint shall be submitted to the director of the school. Whether or not the problem or complaint has been resolved to his/her satisfaction by the school, the student may direct any problem or complaint to the State Board of Career Colleges and Schools, 30 East Broad Street, Suite 2481, Columbus, OH; Phone (614)466-2752 or (877)275-4219.

I acknowledge that I have read this enrollment agreement.

Applicant Signature*

Parent or Guardian Signature (if applicable)

Date:
09/25/2023

School Representative Signature

Date:
09/25/2023

DENTAL ASSISTANT PRO
Enrollment Financial Agreement

767 Columbus Avenue, Lebanon, OH 45036 Reg. #04-11-1742T

I have selected the following payment option:*

Option #1
Total: $3775

Option #2
Total: $3800

Option #3
Total: $3825

Option #4
Tuition Installment Plan

Registration Fee

$125

Due with Registration Form

Book Fee and Tuition

$3,650

Due 2 weeks before program start date

Total

$3,775

Registration Fee, Book Fee & Tuition

Registration Fee

$125

Due with Registration Form

Down Payment

$1425

Due 2 weeks before program start date

9 Weekly Payments

$250

Starting Wednesday before program start date

Total

$3,800

Registration Fee, Book Fee & Tuition

Administrative fee costs $25.00 extra. Autopay required.

Registration Fee

$125

Due with Registration Form

Down Payment

$1180

Due 2 weeks before program start date

9 Weekly Payments

$280

Starting Wednesday before program start date

Total

$3,825

Registration Fee, Book Fee & Tuition

Administrative fee costs $50.00 extra. Autopay required.

Registration
Fee

$125

Due with Registration Form

Down
Payment

$850

Due 2 weeks before program start date

12 Monthly
Payments

$253.90

1st Payment due 30 days after program start date

Financing
Fee

$96.75

Admin
Fee

$150

Total

$4,021.80

Down Payment and Loan which includes all Fees

We accept all major credit cards.

PLEASE NOTE TUITION IS DUE AND PAYABLE IN ADVANCE. A STUDENT WHO IS NOT CURRENT WITH HIS OR HER WEEKLY PAYMENTS OR STUDENT LOAN PAYMENTS CANNOT ATTEND CLASS UNTIL CURRENT. PAYMENT IN FULL MUST BE RECEIVED BY THE 9TH WEEK OF CLASS TO RECEIVE CERTIFICATE OF COMPLETION.

Applicant Name

First Last

Applicant Signature*

Date:
09/25/2023

Hidden

School Representative

Signature

Name

This field is for validation purposes and should be left unchanged.

Dental Assistant Pro Online Enrollment Agreement

DENTAL ASSISTANT PRO Enrollment Agreement

DENTAL ASSISTANT PRO Refund Policy

DENTAL ASSISTANT PRO Enrollment Grievance Agreement

DENTAL ASSISTANT PRO Enrollment Financial Agreement

DENTAL ASSISTANT PRO
Enrollment Agreement

DENTAL ASSISTANT PRO
Refund Policy

DENTAL ASSISTANT PRO
Enrollment Grievance Agreement

DENTAL ASSISTANT PRO
Enrollment Financial Agreement