Registration Process

Register for Course

Reserve a Seat

Complete Enrollment

ARKANSAS

Enrollment Agreement

Please complete the form below, all fields are required.

Enrollment Agreement Location

Semester Enrollment

Preferred class attendance day

Class attendance day preference is not guaranteed and is subject to availability. Please contact us for questions.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Scrub Size

Please select the size of the scrubs the school will issue at orientation and collect at the end of the course.

Select Your Form of Payment

Select Payment Option

Paid in Full - $300 Discount (Standard $3650)

Plan A: 1 Payments - $250 Deposit and Balance Due on first day of class (Standard $3700))

Plan B: 3 Payments - $250 Deposit and 3 Installment Payments Due 2nd, 4th, & 6th Week of Class (Standard $1234)

Plan C: 9 Payments - $250 Deposit and 9 Payments (Standard $412)

Name of Cardholder who will be Paying (if not student)

Student Acknowledgements (initial)

The Student Understands: 1. The School does not accept credit for previous education, training, work experience (experimental learning), or CLEP. 2. The School does not guarantee job placement to graduates upon program/course completion or upon graduation. 3. The School reserves the right to reschedule the program start date when the number of students scheduled is too small. 4. The School will not be responsible for any statement of policy or procedure that does not appear in the School catalog. 5. The School reserves the right to discontinue the student’s training for unsatisfactory progress, nonpayment of tuition or failure to abide by School rules 6. Transfer of Credits - It should not be assumed that any programs described in the School catalog could be transferred to another institution. The School does not guarantee the transferability of credits to a college, university or institution. Any decision on the comparability, appropriateness and applicability of credits and whether they should be accepted is the decision of the receiving institution. 7. This document does not constitute a binding agreement until accepted in writing by all parties.

Cancellation and Refund Policy: (Initial)

A full refund shall be granted to any student who cancels the enrollment contract within seventy-two (72) hours (until midnight of the third day excluding Saturdays, Sundays, or legal holidays) after the enrollment contract is submitted by the prospective student. 1. All refunds shall be made by Apex Dental Education to the student or lender no later than thirty (30) calendar days after the student withdraws or is terminated from the program. Proof of refund(s) shall be placed in the student's file. If refunds are made by check, proof shall be a photocopy of the refund check and proof that it has cleared the bank such as the bank statement. If refunds are made by electronic funds transfer, the refund shall be recorded on the student's account record and proof of refund shall be provided upon request. If refunds are made to a credit card, the credit receipt shall serve as proof of the refund. 2. The official date of termination or withdrawal of a student shall be determined in the following manner: a. The date on which the school receives written notice of the student's intention to discontinue the training program; or b. The date on which the student violates published school policy, which provides for termination; or c. Should a student fail to return from an excused leave of absence, the effective date of termination for a student on an extended leave of absence, or a leave of absence is the earlier of the date the school determines the student is not returning, or the day following the expected date of return 3. In the event Apex Dental Education discontinues a Program in which students are enrolled, a full refund of all tuition and fees is due. Refunds shall be made within 15 days of the last class meeting date. 4. Apex Dental Education shall adhere to the following refund policy: a. The registration fee not to exceed one hundred dollars ($100) paid to Apex Dental Education by the student may be retained as a registration or application fee. b. All tuition paid in excess of the registration fee of not more than one hundred dollars ($100) shall be refundable. i. The refund shall be based on the cost and length of the program. All tuition beyond the current enrollment period shall be refunded when a student terminates. ii. A full refund will be made of all deposits or payments. If a cancellation is made before the start of the first class. iii. At completion of less than twenty five percent (25%) of the program the refunds shall be made on a pro rata basis. iv. At completion of 25% but less than 50% of the program the student shall be refunded not less than 50% of the tuition. v. At completion of 50% but less than 75% of the program the student shall be refunded not less than 25% of the tuition. vi. At completion of 75% or more of the program no refund is due the student. vii. Those wishing to cancel for illness or personal reasons may resume their course of study in the next class series with no penalty and may repeat the already completed sessions if desired at no additional charge or pick up where they left off with approval by the Program's Director. 5. Students shall be refunded immediately when a course is cancelled and there is not a course required for their program of study available. 6. Transcripts and Certificates: Grades shall be posted to transcripts within thirty (30) calendar days of the end of each term or upon withdrawal or completion of a student, an updated transcript shall be available upon request after that time. 7. There is no charge for the original copy of your certificate. However, there is a$ 20.00 charge for each additional copy. Official transcripts of students' records are issued only on written request. Transcripts must be requested 24 hours in advance. If a student who has attended the program allows licensing to expire or fails to submit the final step, (Jurisprudence Test) before they receive their permit, Apex Dental Education can assist with the renewal process and/or submittal to the dental board. There will be a fee of $50 payable by check to Apex Dental Education. The student will also be responsible for any fees to the dental board.

Photo Release

I grant to Apex Dental Education Network, its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize Apex Dental Education Network, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Apex Dental Education Network may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

Yes

E-Signature

By signing below, the student agrees to pay Apex Dental Education the total stated tuition and fees. The school agrees to provide the dental assistant training in accordance with the provisions of the school’s curriculum outline. Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met, the school will award the Dental Assisting Certificate to the student. The student and school understand that this Enrollment Agreement, which includes the Refund Policy, may not be amended except in writing and signed by both parties.